Individual provider Active NPI

Keerti Kantilal Bhanushali, M.D.

  • Nephrology Physician
  • Augusta, GA
National Provider Identifier
1376851170
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
73734 Issued in GA
Practice address
1350 Walton Way
Augusta, GA 30901-2612
Phone
(706) 774-5795
Fax
(706) 774-5792
NPI assigned
Sep 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 073734 GA
Hospitalist Physician 208M00000X 73734 GA
Nephrology Physician 207RN0300X 73734 GA Primary

Addresses

Primary practice location

1350 Walton Way
Augusta, GA 30901-2612

Mailing address

PO Box 1705
Augusta, GA 30903-1705
Phone (706) 774-7263

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
I20160106000464 GA Practitioner - Internal MedicinePractitioner - Nephrology 2567693955 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Hospitalist Physicians LLCGroup PAC ID 1951299163, 503 clinicians

Practice addresses (Care Compare)

1350 Walton Way
Augusta, GA 30901-2612
Phone (706) 774-2183

35 Collier Rd NW
Suite 635
Atlanta, GA 30309-1611
Phone (404) 367-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
73734GAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Physician Services - Southeast Professional Corporation Hospitalist CurrentSince Apr 1, 2022 Accepting new patients
Piedmont Hospitalist Physicians LLC Internal Medicine CurrentSince May 29, 2024 Accepting new patients
University Health Services,Inc Past Accepting new patients

Locations

35 Collier Rd NW
Ste 635
Atlanta, GA 30309
Phone (404) 367-3000

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

1350 Walton Way
Fl 4
Augusta, GA 30901
Phone (706) 774-5795

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

2460 Washington Rd
Thomson, GA 30824
Phone (706) 595-1411

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1376851170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1705",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309031705",
            "telephone_number": "706-774-7263",
            "fax_number": "706-774-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012612",
            "telephone_number": "706-774-5795",
            "fax_number": "706-774-5792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHANUSHALI",
        "first_name": "KEERTI",
        "middle_name": "KANTILAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "073734",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "73734",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "73734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.