Individual provider Active NPI

Krishna Mohan Kunche, M.D

  • Internal Medicine Physician
  • Suwanee, GA
National Provider Identifier
1386846244
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
069516 Issued in GA
Practice address
4375 Johns Creek Pkwy
Suite 320
Suwanee, GA 30024-6085
Phone
(770) 623-1331
Fax
(770) 623-5674
NPI assigned
Jun 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 069516 GA Primary

Addresses

Primary practice location

4375 Johns Creek Pkwy
Suite 320
Suwanee, GA 30024-6085

Mailing address

4375 Johns Creek Pkwy
Suite 320
Suwanee, GA 30024-6085
Phone (770) 623-1331

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Permanente Medical Group

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
I20170418002321 GA Practitioner - Internal Medicine 4981796679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

3495 Piedmont Rd NE
Atlanta, GA 30305-1729
Phone (404) 364-7206

Hospital & facility affiliations

  • Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032
  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • Memorial Hospital Hospital, Belleville, IL, CCN 140185

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Internal Medicine CurrentSince Sep 7, 2021 Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

3650 Steve Reynolds Blvd
Duluth, GA 30096
Phone (770) 931-6010

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 and National Provider Directory roles.

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": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1386846244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 JOHNS CREEK PKWY",
            "address_2": "SUITE 320",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246085",
            "telephone_number": "770-623-1331",
            "fax_number": "770-623-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 JOHNS CREEK PKWY",
            "address_2": "SUITE 320",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246085",
            "telephone_number": "770-623-1331",
            "fax_number": "770-623-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNCHE",
        "first_name": "KRISHNA",
        "middle_name": "MOHAN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "069516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3650 Steve Reynolds Blvd",
            "city": "Duluth",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300964506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.