NPIMap

Individual provider Active NPI

Vijitha Prasad, M.D.

  • Internal Medicine Physician
  • Swainsboro, GA
National Provider Identifier
1275520090
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
GA040520 Issued in GA
Practice address
544 W Church St
Swainsboro, GA 30401-3230
Phone
(478) 237-2527
Fax
(478) 237-7406
NPI assigned
Oct 6, 2005
Last updated
Oct 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X GA040520 GA Primary

Addresses

Primary practice location

544 W Church St
Swainsboro, GA 30401-3230

Mailing address

4300 N Point Pkwy Ste 300
Alpharetta, GA 30022-4102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040401000092 GA Practitioner - Internal MedicinePractitioner - Infectious DiseasePractitioner - Emergency Medicine 7618969767 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeast Medical Group, P.C.Group PAC ID 3577559673, 139 clinicians

Practice addresses (Care Compare)

117 Kite Rd
Swainsboro, GA 30401-3231
Phone (478) 289-1341

1255 Friendship Rd
Suite 130
Braselton, GA 30517-5617
Phone (770) 442-1911

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
GA040520GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emanuel County Hospital Authority CurrentSince Jun 15, 2021 Accepting new patients
Emanuel County Hospital Authority CurrentSince Jan 1, 2013 Accepting new patients
Southeast Medical Group, P.C. CurrentSince Oct 18, 2024 Accepting new patients
South Georgia Internal Medicine,PC Internal Medicine CurrentSince Apr 1, 2004 Accepting new patients
Emanuel County Hospital Authority Past Accepting new patients
Erx Group, LLC Past Accepting new patients

Locations

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

4300 Northpoint Pkwy
Ste 300
Johns Creek, GA 30022
Phone (770) 518-4406

117 Kite Rd
Swainsboro, GA 30401
Phone (248) 972-8725

117 Kite Rd
Fl 2
Swainsboro, GA 30401
Phone (478) 289-1150

125 Victory Dr
#B
Swainsboro, GA 30401
Phone (678) 736-6000

305 Kite Rd
Swainsboro, GA 30401
Phone (478) 237-2144

544 W Church St
Swainsboro, GA 30401
Phone (478) 237-2527

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA
  • Direct secure messaging: vijitha.prasad@gadirect.net
  • Direct secure messaging: vijitha.prasad@sgim.gadirect.net

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Emanuel Medical CenterSwainsboro, GA, CCN 110109 Hospital Corporate Director Jan 1, 2013
Emanuel Medical CenterSwainsboro, GA, CCN 11U109 Hospital Corporate Director Jan 1, 2013
Emanuel Medical CenterSwainsboro, GA, CCN 11S109 Hospital Corporate Director Jan 1, 2013
Ray Medical ClinicSwainsboro, GA, CCN 118526 Rural health clinic Corporate Director Jan 1, 2013

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1275520090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 N POINT PKWY STE 300",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300224102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 W CHURCH ST",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304013230",
            "telephone_number": "478-237-2527",
            "fax_number": "478-237-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRASAD",
        "first_name": "VIJITHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "GA040520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swainsboro, GA

Sources for this page

Verify at the official NPI Registry.