Sarvotham Kini, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

034170 Issued in GA

Practice address

108 Spear Rd
Suite 309
Athens, GA 30602-0001

Phone

(706) 542-9592

Fax

(706) 713-2222

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Sam Kini Other 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.

• Observation Medicine Specialists LLC

  • Hospitalist Physician
  • Austell, GA
  • NPI 1093026015

  Emergency Medicine

  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1407964356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 WHITE HORSE LN SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806408",
            "telephone_number": "843-412-0072",
            "fax_number": "706-713-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 SPEAR RD",
            "address_2": "SUITE 309",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306020001",
            "telephone_number": "706-542-9592",
            "fax_number": "706-713-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINI",
        "first_name": "SARVOTHAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "13292",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "034170",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "034170",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "034170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132920",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003100353A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAM",
            "last_name": "KINI",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Eric Teal Kinard, O.D.
• Elizabeth Kindamo, MS, RDN, LD
• Carly Joy King, MT-BC, LP-MT
• Michelle Lisa King, LCSW
• Patrick E King, DPT
• Chelsea Alexandra Kinney
• Colleen Kinsella
• Kiravani Voice
• Jessica Elaine Kirby, LPC
• Carey Kirk, LAPC

• Internal Medicine Physician in Athens, GA
• Providers in Athens, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; 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.