Naga Bhavani Meduri, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

057104 Issued in GA

Practice address

1400 Northside Forsyth Drive, Suite 350
Kaiser Permanente Forsyth Medical Center
Cumming, GA 30041

Phone

(214) 265-1818

Fax

(214) 265-1806

NPI assigned

Sep 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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

Specialty

Dermatology

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Modern Dermatology AtlantaGroup PAC ID 1658623889, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Modern Dermatology Atlanta

  • Dermatology Physician
  • Dunwoody, GA
  • NPI 1164947115
  Medicare reassignment Care Compare group NPD Authorized official
• Northwestern Memorial Physicians Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1538111299

  Dermatology

  NPD (past)

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1346344405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT ROAD, NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30305",
            "telephone_number": "404-364-7070",
            "fax_number": "972-860-8679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 NORTHSIDE FORSYTH DRIVE, SUITE 350",
            "address_2": "KAISER PERMANENTE FORSYTH MEDICAL CENTER",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30041",
            "telephone_number": "214-265-1818",
            "fax_number": "214-265-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDURI",
        "first_name": "NAGA",
        "middle_name": "BHAVANI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "M4876",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "057104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Ann Medearis, M.DIV., M.A.
• Medica Imaging, LLC
• Medical Equipment Specialists
• Vanessa Medina
• Brittany Morgan Medlin
• Bailey Lester Meeks
• Colleen Meeks, LMSW
• Melissa Sanders Meeks
• Michelle Renee Meinhart, MSW
• Karen Joan Melde, NP

• Dermatology Physician in Cumming, GA
• Providers in Cumming, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; 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.