Chudamani Rao Polkampally, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

74563 Issued in GA

Practice address

225 Country Club Dr Ste 140
Stockbridge, GA 30281-7392

Phone

(770) 415-5889

Fax

(770) 415-5890

NPI assigned

Oct 6, 2006

Last updated

Apr 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Chudamani Kasuganti Rao Other name

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

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fresenius Kidney Care McDonough Dialysis facility, McDonough, GA, CCN 852552
• Fresenius Medical Care Henry County Dialysis facility, Stockbridge, GA, CCN 112659
• DaVita Eagles Landing Dialysis Dialysis facility, Stockbridge, GA, CCN 852543
• Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
• Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083

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.

• Eagles Landing Nephrology and Hypertension LLC

  • Nephrology Physician
  • Stockbridge, GA
  • NPI 1205294378
  Medicare reassignment NPD Authorized official

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

• Fresenius Medical Care McDonough, LLC

  dba Fresenius Kidney Care McDonough

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • McDonough, GA
  • NPI 1174125603

  Dialysis facility

  Care Compare affiliation Name & address match
• Henry Dialysis Center, LLC

  dba Fresenius Medical Care Henry County

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Stockbridge, GA
  • NPI 1821100645

  Dialysis facility

  Care Compare affiliation Name & address match
• Total Renal Care Inc

  dba Eagles Landing Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Stockbridge, GA
  • NPI 1528584448

  Dialysis facility

  Care Compare affiliation Name & address match
• Piedmont Henry Hospital, Inc.

  • General Acute Care Hospital
  • Stockbridge, GA
  • NPI 1225034333
  Care Compare affiliation
• Piedmont Hospital, Inc

  dba Piedmont Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1962461681
  Care Compare affiliation

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1275620452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 COUNTRY CLUB DR STE 140",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817392",
            "telephone_number": "770-415-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 COUNTRY CLUB DR STE 140",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817392",
            "telephone_number": "770-415-5889",
            "fax_number": "770-415-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLKAMPALLY",
        "first_name": "CHUDAMANI",
        "middle_name": "RAO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0101241347",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.009009",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "P8066",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "74563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "339316701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMDCR",
            "identifier": "P01393816",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHUDAMANI",
            "last_name": "RAO",
            "middle_name": "KASUGANTI",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Leenyia Pitts
• Mary Rose Planchon, COTA
• Ana Maria Platon, MD
• Philip G. Ploska, MD
• Carlena Suzette Plunkett, FNP
• Brittany Ponder
• Robert M Poole, PT
• Mary V Poore, L.C.S.W
• D'Amber Shaunise Porter
• Jake J Porter III, M.D., MPH

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; 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.
• 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.