Active NPI
Kamlesh D. Nayak, MD, PC
- Cardiovascular Disease Physician
- Douglasville, GA
National Provider Identifier
1497815385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 032003
- Legal business name
- KAMLESH D. NAYAK, MD, PC
- Practice address
- 4904 Timber Ridge Dr
Ste 102
Douglasville, GA 30135 - Phone
- (770) 489-8165
- NPI assigned
- Dec 11, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kamlesh D Nayak, MD
- Title
- Physician
- Phone
- (770) 489-8165
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 032003 | GA | Primary |
Addresses
Primary practice location
4904 Timber Ridge Dr
Ste 102
Douglasville, GA 30135
Mailing address
4904 Timber Ridge Dr
Ste 102
Douglasville, GA 30135
Phone (770) 489-8165
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00517283C | Medicaid | GA |
National Provider Directory
National Provider DirectoryLocations
8954 Hospital Dr
Ste 125D
Douglasville, GA 30134
Phone (678) 715-8500
Interoperability endpoints
- https://api.platform.athenahealth.com/5531/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gynecology Physician
- Douglasville, GA
- NPI 1588625248
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1212105600000",
"number": "1497815385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4904 TIMBER RIDGE DR",
"address_2": "STE 102",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "30135",
"telephone_number": "770-489-8165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4904 TIMBER RIDGE DR",
"address_2": "STE 102",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "30135",
"telephone_number": "770-489-8165"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KAMLESH D. NAYAK, MD, PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-11",
"last_updated": "2008-05-30",
"status": "A",
"authorized_official_last_name": "NAYAK",
"authorized_official_first_name": "KAMLESH",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "770-489-8165",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "GA",
"license": "032003",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00517283C",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.