Individual provider Active NPI

Kanitha K Sar, APRN, FNP-BC

  • Family Nurse Practitioner
  • Cumming, GA
National Provider Identifier
1417402108
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN195012 Issued in GA
Practice address
5834 N Vickery St
Cumming, GA 30040
Phone
(678) 400-5043
Fax
(404) 328-7528
NPI assigned
Aug 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN195012 GA Primary

Addresses

Primary practice location

5834 N Vickery St
Cumming, GA 30040

Mailing address

505 Lakeland PLZ Ste 438
Cumming, GA 30040-2807
Phone (678) 400-5043

Other practice location 1

81 Northside Dawson Dr Ste 100
Dawsonville, GA 30534-7164
Phone (706) 216-6000

Other practice location 2

610 Peachtree Pkwy Ste 100
Cumming, GA 30041-9762
Phone (678) 513-5260

Other names 1

  • Cindy Sar Other name

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
I20170220001923 GA Practitioner - Nurse Practitioner 8729361688 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Urgent Care Holding LLCGroup PAC ID 4587984695, 77 clinicians

Practice addresses (Care Compare)

81 Northside Dawson Dr
Suite 100a
Dawsonville, GA 30534-7166
Phone (706) 216-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN195012GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Guo'S Medical Clinic, LLC CurrentSince Jan 19, 2017 Accepting new patients

Locations

1465 Haw Creek Cir E
Ste 703
Cumming, GA 30041
Phone (770) 781-1560

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13192/brand/2/csg/1/fhir/r4

Organizations & group practices 2

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": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1417402108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 LAKELAND PLZ STE 438",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402807",
            "telephone_number": "678-400-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5834 N VICKERY ST",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30040",
            "telephone_number": "678-400-5043",
            "fax_number": "404-328-7528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "81 Northside Dawson Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Dawsonville",
            "state": "GA",
            "postal_code": "305347164",
            "country_code": "US",
            "telephone_number": "706-216-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "610 Peachtree Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300419762",
            "country_code": "US",
            "telephone_number": "678-513-5260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAR",
        "first_name": "KANITHA",
        "middle_name": "K",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN195012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CINDY",
            "last_name": "SAR",
            "credential": "APRN, FNP-BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.