Individual provider Active NPI

Karleena Regina-Marie Tuggle, M.D.

  • Surgery Physician
  • Atlanta, GA
National Provider Identifier
1467609107
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0000000 Issued in DC
Practice address
4200 Northside Pkwy
BLD #8
Atlanta, GA 30327
Phone
(404) 881-8020
Fax
(678) 539-3080
NPI assigned
Aug 25, 2008
Last updated
Nov 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0000000 DC Primary

Addresses

Primary practice location

4200 Northside Pkwy
BLD #8
Atlanta, GA 30327

Mailing address

4200 Northside Pkwy
BLD #8
Atlanta, GA 30327
Phone (404) 881-8020

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
I20110727000418 GA Practitioner - General Surgery 4688842115 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000000DCMDHome Health Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Regional Physicians Management Group, LLC Surgery CurrentSince Mar 18, 2019 Accepting new patients
Peachtree Surgical & Bariatrics CurrentSince Jul 1, 2011 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

285 Boulevard NE
Ste 120
Atlanta, GA 30312
Phone (404) 881-8020

4200 Northside Pkwy NW
#8
Atlanta, GA 30327
Phone (404) 881-8020

4200 Northside Pkwy NW
Bldg 8
Atlanta, GA 30327
Phone (404) 233-3833

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

33 Upper Riverdale Rd SW
Ste 17
Riverdale, GA 30274
Phone (770) 897-7043

Interoperability endpoints

  • Direct secure messaging: ktuggle@direct.southernregional.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1467609107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 NORTHSIDE PKWY",
            "address_2": "BLD #8",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30327",
            "telephone_number": "404-881-8020",
            "fax_number": "678-539-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 NORTHSIDE PKWY",
            "address_2": "BLD #8",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30327",
            "telephone_number": "404-881-8020",
            "fax_number": "678-539-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUGGLE",
        "first_name": "KARLEENA",
        "middle_name": "REGINA-MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-25",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "DC",
            "license": "0000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.