Organization Active NPI

Alpha OBGYN Inc

  • Obstetrics Physician
  • Alpharetta, GA
National Provider Identifier
1235533001
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
060596 Issued in GA
Legal business name
ALPHA OBGYN INC
Practice address
2905 Jordan CT
Suite G
Alpharetta, GA 30004
Phone
(678) 335-9223
Fax
(678) 335-9236
NPI assigned
Oct 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Authorized official

Name
Sowmya ReddyNPI 1295829059
Title
Physician
Phone
(678) 335-9223

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VX0000X 060596 GA Primary

Addresses

Primary practice location

2905 Jordan CT
Suite G
Alpharetta, GA 30004

Mailing address

2905 Jordan CT Ste G
Alpharetta, GA 30004-8966
Phone (678) 335-9223

Other identifiers 3

IdentifierTypeStateIssuer
450094819EMedicaidGA
202I164160OtherWELLCARE PTAN
569399OtherGAWELLCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150311001500 GA Part B Supplier - Clinic/Group Practice 8729304654 Receives reassigned benefits from 1 practitioner
Practice locations: Alpharetta, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2084886Alpha OBGYN2905 Jordan Court, Alpharetta, GA 30004Provider-performed microscopyOct 1, 2026

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9819/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1235533001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 JORDAN CT STE G",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300048966",
            "telephone_number": "678-335-9223",
            "fax_number": "678-335-9236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 JORDAN CT",
            "address_2": "SUITE G",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30004",
            "telephone_number": "678-335-9223",
            "fax_number": "678-335-9236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA OBGYN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-22",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "SOWMYA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "678-335-9223"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "GA",
            "license": "060596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "450094819E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE PTAN",
            "identifier": "202I164160",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "569399",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.