Individual provider Active NPI

Pusparani Panda, NP

  • Family Nurse Practitioner
  • Athens, GA
National Provider Identifier
1295105492
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN216011 Issued in GA
Practice address
1061 Dowdy Rd
Suite 101
Athens, GA 30606-5700
Phone
(706) 621-7575
Fax
(706) 621-7557
NPI assigned
Sep 30, 2015
Last updated
Sep 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN216011 GA Primary

Addresses

Primary practice location

1061 Dowdy Rd
Suite 101
Athens, GA 30606-5700

Mailing address

1061 Dowdy Rd
Athens, GA 30606-5700
Phone (706) 621-7575

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210309002608 GA Practitioner - Nurse Practitioner 3476859174 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN216011GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
S.Y.a.H. CurrentSince Mar 4, 2021 Accepting new patients
Peachtree Immediate Care FP, LLC CurrentSince Jul 26, 2024 Accepting new patients
Reddy Medical Group LLC Family Past Accepting new patients

Locations

3425 Buford Dr
Ste 200
Buford, GA 30519
Phone (678) 546-0200

590 Lanier Ave W
Fayetteville, GA 30214

1250 Jesse Jewell Pkwy SE
#3
Gainesville, GA 30501

1250 Jesse Jewell Pkwy SE
Ste 300
Gainesville, GA 30501
Phone (770) 532-0800

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

3885 Mundy Mill Rd
Ste 114
Oakwood, GA 30566
Phone (678) 971-1892

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22260/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/AJHBAA/Endpoint/AJHBAA

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1295105492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 DOWDY RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306065700",
            "telephone_number": "706-621-7575",
            "fax_number": "706-621-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 DOWDY RD",
            "address_2": "SUITE 101",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306065700",
            "telephone_number": "706-621-7575",
            "fax_number": "706-621-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDA",
        "first_name": "PUSPARANI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-30",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN216011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.