Individual provider Active NPI

Nazra Baluch, M.D.

  • Family Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1366628117
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
001563 Issued in GA
Practice address
1692 Atkinson Park Cir
Lawrenceville, GA 30043-7937
Phone
(678) 377-4698
NPI assigned
Jan 10, 2008
Last updated
Jan 10, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 001563 GA Primary

Addresses

Primary practice location

1692 Atkinson Park Cir
Lawrenceville, GA 30043-7937

Mailing address

1692 Atkinson Park Cir
Lawrenceville, GA 30043-7937
Phone (678) 377-4698

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
I20220421000838 GA Order and Referring Only - Family PracticePractitioner - Family Practice 5890847446

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001563GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Immediate Med of Dawsonville Past Accepting new patients

Organizations & group practices 1

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": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1366628117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1692 ATKINSON PARK CIR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437937",
            "telephone_number": "678-377-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1692 ATKINSON PARK CIR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437937",
            "telephone_number": "678-377-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALUCH",
        "first_name": "NAZRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "001563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.