Individual provider Active NPI

Anisha Lakshmi Jayachandran

  • Emergency Medicine Physician
  • Newnan, GA
National Provider Identifier
1407645229
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
NA Issued in GA
Practice address
745 Poplar Rd
Newnan, GA 30265-1618
Phone
(770) 400-1000
NPI assigned
May 6, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NA GA Primary

Addresses

Primary practice location

745 Poplar Rd
Newnan, GA 30265-1618

Mailing address

745 Poplar Rd
Newnan, GA 30265-1618
Phone (770) 400-1000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251016003372 GA Practitioner - Physician Assistant 1254828767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercer University School of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 Corporate Blvd
Lafayette, LA 70508-3844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coweta Emergency Group LLC Emergency Medicine CurrentSince Sep 1, 2025 Accepting new patients

Locations

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

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.

NPI Registry JSON

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

{
    "created_epoch": "1746489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1407645229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 POPLAR RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651618",
            "telephone_number": "770-400-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 POPLAR RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651618",
            "telephone_number": "770-400-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYACHANDRAN",
        "first_name": "ANISHA",
        "middle_name": "LAKSHMI",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-06",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "NA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.