Individual provider Active NPI

Amit Kumar, MD

  • Internal Medicine Physician
  • Villa Rica, GA
National Provider Identifier
1295994390
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MT192117 Issued in PA
Practice address
715 Wildwood GLN
Villa Rica, GA 30180-2427
Phone
(610) 739-4386
NPI assigned
Jun 3, 2008
Last updated
Jul 20, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT192117 PA Primary
Internal Medicine Physician 207R00000X 066165 GA

Addresses

Primary practice location

715 Wildwood GLN
Villa Rica, GA 30180-2427

Mailing address

715 Wildwood GLN
Villa Rica, GA 30180-2427
Phone (610) 739-4386

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140226001185 GA Practitioner - Internal Medicine 4880865344 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
066165GAMDInternal Medicine Physician
MT192117PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Dec 3, 2013 Accepting new patients
Au Medical Associates Inc CurrentSince Dec 3, 2013 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1499 Walton Way
Ste 1400
Augusta, GA 30901
Phone (706) 721-4951

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": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1295994390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 WILDWOOD GLN",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301802427",
            "telephone_number": "610-739-4386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 WILDWOOD GLN",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301802427",
            "telephone_number": "610-739-4386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "AMIT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT192117",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "066165",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

Verify at the official NPI Registry.