Csra Health LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

CSRA HEALTH LLC

Practice address

699 Furys Ferry Road
Martinez, GA 30907

Phone

(706) 399-2825

NPI assigned

May 19, 2023

Last updated

May 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Deepa Jagdale, MDNPI 1447412184

Title

Cmo

Phone

(706) 399-2825

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Deepa Sanjay Jagdale, M.D.

  • Pediatrics Physician
  • Martinez, GA
  • NPI 1447412184
  NPD Authorized official

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1467143313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 HIGH HAMPTON DR",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079126",
            "telephone_number": "706-399-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 FURYS FERRY ROAD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "30907",
            "telephone_number": "706-399-2825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSRA HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-10",
        "status": "A",
        "authorized_official_last_name": "JAGDALE",
        "authorized_official_first_name": "DEEPA",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "706-399-2825",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Martinez, GA
• Providers in Martinez, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.