West Cobb Internal Medicine PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

38709 Issued in GA

Legal business name

WEST COBB INTERNAL MEDICINE PC

Practice address

5041 Dallas Hwy
BLDG 2 Suite E West Cobb Internal Medicine PC
Powder Springs, GA 30127

Phone

(770) 218-1880

Fax

(770) 218-1088

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Chidambaram Raghavan, MDNPI 1326237322

Title

Medical Director

Phone

(770) 218-1880

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Chidambaram Raghavan MD Other name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chidambaram Raghavan, MD

  • Internal Medicine Physician
  • Powder Springs, GA
  • NPI 1326237322
  Medicare reassignment Care Compare group NPD Authorized official
• Karan Raghavan, MD

  • Family Medicine Physician
  • Columbus, GA
  • NPI 1518596683
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1467524330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5041 DALLAS HIGHWAY",
            "address_2": "BLDG 2 SUITE E WEST COBB INTERNAL MEDICINE PC",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "30127",
            "telephone_number": "770-218-1880",
            "fax_number": "770-218-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5041 DALLAS HWY",
            "address_2": "BLDG 2 SUITE E WEST COBB INTERNAL MEDICINE PC",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "30127",
            "telephone_number": "770-218-1880",
            "fax_number": "770-218-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COBB INTERNAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "RAGHAVAN",
        "authorized_official_first_name": "CHIDAMBARAM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-218-1880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "38709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00626117A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4562104",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0400005",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "617437",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chidambaram Raghavan MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Yokeca Nicole Watts, D.M.D.
• Wellstar Medical Group, LLC
• Wellstar Powder Springs Medical Center, LLC
• Margaret A Wenclawiak, PT
• West Cobb Chiropractic
• West Cobb Physical Therapy
• Vivian White-Wormley
• Syreeta S. Whitfield
• Karl Alan Whitlock, PSY.D.
• Vincent Jamar Wilcox, PHARMD

• Internal Medicine Physician in Powder Springs, GA
• Providers in Powder Springs, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.