Individual provider Active NPI

Azhar Nisar, MD

  • Internal Medicine Physician
  • Dalton, GA
National Provider Identifier
1437105046
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G42375 Issued in GA
Practice address
1407 Chattanooga Ave
Suite B
Dalton, GA 30720-2631
Phone
(706) 279-0470
Fax
(706) 279-1758
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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 G42375 GA Primary

Addresses

Primary practice location

1407 Chattanooga Ave
Suite B
Dalton, GA 30720-2631

Mailing address

1407 Chattanooga Ave
Suite B
Dalton, GA 30720-2631
Phone (706) 279-0470

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
I20041203000308 GA Practitioner - Internal Medicine 3072579879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1407 Chattanooga Ave
Suite B
Dalton, GA 30720-2631
Phone (706) 279-0470

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G42375GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nisar Medical Center, Inc. CurrentSince Jul 18, 2008 Accepting new patients
Internal Medicine Center, Inc. Internal Medicine Past Accepting new patients

Locations

1407 Chattanooga Ave
#B
Dalton, GA 30720
Phone (706) 279-0047

Interoperability endpoints

  • Direct secure messaging: azhar.nisar@nmci-ga.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/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.

Hospital & facility affiliations 5

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1437105046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 CHATTANOOGA AVE",
            "address_2": "SUITE B",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202631",
            "telephone_number": "706-279-0470",
            "fax_number": "706-279-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 CHATTANOOGA AVE",
            "address_2": "SUITE B",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202631",
            "telephone_number": "706-279-0470",
            "fax_number": "706-279-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISAR",
        "first_name": "AZHAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "G42375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.