Christelle Bakatukanda Chiza, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

16474 Issued in GA

Practice address

1459 Laney Walker Blvd
Augusta, GA 30912-0002

Phone

(706) 721-7005

NPI assigned

Jun 10, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Christelle T Bakatukanda Former name

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

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.

• Medical College of Georgia

  • General Acute Care Hospital
  • Augusta, GA
  • NPI 1891680385
  NPD

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1376385591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2127 KINSALE AVE",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308135983",
            "telephone_number": "404-893-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 LANEY WALKER BLVD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120002",
            "telephone_number": "706-721-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIZA",
        "first_name": "CHRISTELLE",
        "middle_name": "BAKATUKANDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "16474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTELLE",
            "last_name": "BAKATUKANDA",
            "middle_name": "T",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ava Gabrielle Chiovatero
• Ioana Chirca, MD
• Alexandria Chisholm
• Elaine Maclin Chisholm, RN
• Ronald Basil Chismar, NURSE PRACTIONER
• Chizik Enterprises International, LLC
• Esther Cho, PHARMD
• Hyosun Cho
• Kyungho Cho, DAOM LAC
• Lindsey Turner Choi, PT

• Family Medicine Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.