Individual provider Active NPI

Swachitha Kothapally, MD

  • Family Medicine Physician
  • Cumming, GA
National Provider Identifier
1366850588
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
077170 Issued in GA
Practice address
3850 Windermere Pkwy
Ste 105
Cumming, GA 30041-7002
Phone
(678) 455-2800
Fax
(770) 888-9998
NPI assigned
Jul 31, 2014
Last updated
Apr 11, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 077170 GA Primary

Addresses

Primary practice location

3850 Windermere Pkwy
Ste 105
Cumming, GA 30041-7002

Mailing address

3850 Windermere Pkwy
Ste 105
Cumming, GA 30041-7002
Phone (678) 455-2800

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
I20170613000606 GA Practitioner - Family Practice 9133425523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3850 Windermere Pkwy
Suite 105
Cumming, GA 30041-7002
Phone (678) 455-2800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services, LLC CurrentSince May 24, 2017 Accepting new patients
Northside Primary Care Professional Services,LLC Family Medicine CurrentSince May 24, 2017 Accepting new patients

Locations

3850 Windermere Pkwy
Ste 105
Cumming, GA 30041
Phone (678) 455-2800

1285 Upper Hembree Rd
Ste 205
Roswell, GA 30076
Phone (770) 521-1587

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

3350 Paddocks Pkwy
#3350A
Suwanee, GA 30024
Phone (678) 474-9633

Interoperability endpoints

  • Direct secure messaging: swachitha.kothapally@wmc.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1366850588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 WINDERMERE PKWY",
            "address_2": "STE 105",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417002",
            "telephone_number": "678-455-2800",
            "fax_number": "770-888-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 WINDERMERE PKWY",
            "address_2": "STE 105",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417002",
            "telephone_number": "678-455-2800",
            "fax_number": "770-888-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTHAPALLY",
        "first_name": "SWACHITHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "077170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.