Active NPI
Deepak Bhagwandas, PT,MD
- Physical Therapist
- Riverdale, GA
National Provider Identifier
1447329263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT004124
- Practice address
- 7529 Shannon Oak Dr
Riverdale, GA 30296-1445 - Phone
- (770) 909-1057
- Fax
- (770) 909-1057
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 25720 | FL | |
| Physical Therapist | 225100000X | PT004124 | GA | Primary |
Addresses
Primary practice location
7529 Shannon Oak Dr
Riverdale, GA 30296-1445
Mailing address
7529,Shannon Oak Dr
Riverdale, GA 30296-1445
Phone (770) 909-1057
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT004124 | Other | GA | STATE LISC NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25720 | FL | MD | Internal Medicine Physician |
| PT004124 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520294400000",
"number": "1447329263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7529,SHANNON OAK DR",
"city": "RIVERDALE",
"state": "GA",
"postal_code": "302961445",
"telephone_number": "770-909-1057",
"fax_number": "770-909-1057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7529 SHANNON OAK DR",
"city": "RIVERDALE",
"state": "GA",
"postal_code": "302961445",
"telephone_number": "770-909-1057",
"fax_number": "770-909-1057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BHAGWANDAS",
"first_name": "DEEPAK",
"credential": "PT,MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2018-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "25720",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT004124",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LISC NUMBER",
"identifier": "PT004124",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverdale, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.