Jalaja P Siddappa, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

017085 Issued in GA

Practice address

3073 Panthersville Rd
Patient Accounts
Decatur, GA 30034-3828

Phone

(404) 212-5454

Fax

(404) 243-2159

NPI assigned

Jan 29, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jalaja Patil Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Dekalb County Board of Health

  • Public Health or Welfare Agency
  • Decatur, GA
  • NPI 1992801021
  NPD (past)
• Georgia Department of Human Resources

  • Psychiatric Hospital
  • Columbus, GA
  • NPI 1144224767
  NPD (past)

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1386821726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370407",
            "address_2": "PATIENT ACCOUNTS OFFICE",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300370407",
            "telephone_number": "404-212-5454",
            "fax_number": "404-243-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3073 PANTHERSVILLE RD",
            "address_2": "PATIENT ACCOUNTS",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300343828",
            "telephone_number": "404-212-5454",
            "fax_number": "404-243-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDAPPA",
        "first_name": "JALAJA",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "017085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JALAJA",
            "last_name": "PATIL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rosalie Kaye Shultz, BSN
• James F Shumake, D.MIN.
• Lilly Marie Shupe, ATC, LAT, OTC, OT-SC
• Susan Shwartz, PH.D.
• Shweet Behavior, LLC
• Umair Siddiqi, DPM
• Ruth Helen Sidor, APRN
• Ann M. Siegel, M.D.
• Donald C Siegel, M.D.,F.A.C.S.
• Cindy Cohen Siegler, LCSW

• Family Medicine Physician in Decatur, GA
• Providers in Decatur, 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 Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.