Individual provider Active NPI

Rachana Mendpara, MD

  • Internal Medicine Physician
  • Gainesville, GA
National Provider Identifier
1417454125
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
89412 Issued in GA
Practice address
1439 Jesse Jewell Pkwy NE Ste 202
Gainesville, GA 30501-3806
Phone
(770) 219-0023
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 89412 GA Primary

Addresses

Primary practice location

1439 Jesse Jewell Pkwy NE Ste 202
Gainesville, GA 30501-3806

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-7573

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rmendpara113767@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010478GAMDMental Health Counselor

Interoperability endpoints

  • Direct secure messaging: rachana.mendpara.1@8478.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1417454125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 JESSE JEWELL PKWY NE STE 202",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013806",
            "telephone_number": "770-219-0023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Waters Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-350-7573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDPARA",
        "first_name": "RACHANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "89412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmendpara113767@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1439 Jesse Jewell Pkwy NE Ste 202",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.