Samrajya L.K. Gogineni, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

025160 Issued in GA

Practice address

1390 US Highway 19 S
Leesburg, GA 31763-4831

Phone

(229) 312-7490

Fax

(229) 312-7495

NPI assigned

Oct 4, 2006

Last updated

Nov 18, 2011By 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 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment NPD
• Phoebe Dorminy Surgical Associates

  • Clinic/Center
  • Fitzgerald, GA
  • NPI 1164703781
  NPD
• Phoebe Putney Memorial Hospital, Inc.

  dba Phoebe Family Medical Center - Pelham

  • Rural Health Clinic/Center
  • Pelham, GA
  • NPI 1821239765
  NPD (past)
• Phoebe Putney Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Camilla, GA
  • NPI 1821293788
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1306932983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84009",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319084009",
            "telephone_number": "229-312-5800",
            "fax_number": "229-312-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 US HIGHWAY 19 S",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317634831",
            "telephone_number": "229-312-7490",
            "fax_number": "229-312-7495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOGINENI",
        "first_name": "SAMRAJYA",
        "middle_name": "L.K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "025160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gateway Medspa LLC Dba Dana (Dana Inc.)
• Georgia CVS Pharmacy, LLC (CVS Pharmacy #02593)
• Nayonda Teemer Gibson, ATC, LAT
• Amy Elaine Giles, CCC-SLP
• Hannah Elizabeth Gilmore, PHARM.D.
• Eric Scott Gordon, O.D.
• Lavenice J Grace
• Mary Elizabeth Griffin, CPNP
• Katherine Lynette Hadley
• Kimberly Minchew Hamilton

• Internal Medicine Physician in Leesburg, GA
• Providers in Leesburg, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.