Anand T Shantha, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

050677 Issued in GA

Practice address

119 N Park TRL
Stockbridge, GA 30281-7373

Phone

(770) 389-3739

Fax

(770) 389-6565

NPI assigned

Aug 6, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Georgia Urology PA

  • Urology Physician
  • Riverdale, GA
  • NPI 1245250646
  Medicare reassignment NPD
• Urological Professional Services, LLC

  • Urology Physician
  • Atlanta, GA
  • NPI 1033521810
  Medicare reassignment NPD
• Georgia Urology, PA

  dba Georgia Urology ASC Gwinnett

  • Ambulatory Surgical Clinic/Center
  • Lawrenceville, GA
  • NPI 1083851497
  NPD
• Georgia Urology, PA

  • Ambulatory Surgical Clinic/Center
  • Braselton, GA
  • NPI 1861222119
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1225047301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-284-4040",
            "fax_number": "678-284-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 N PARK TRL",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817373",
            "telephone_number": "770-389-3739",
            "fax_number": "770-389-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANTHA",
        "first_name": "ANAND",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "050677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000972804A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "340020189",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pravin Shah
• Tallapragada Shankar, MD
• Andrea Shannon, D.C.
• Larry Roland Shannon II, MD
• Shanice Shannon, PA
• Sarah Shapiro, PA-C
• Toshi Shareef
• Omar Mohammed Shariff, D.D.S.
• Pallavi Sharma, M.D.
• Sanjay Sharma, MD

• Urology Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Urology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.