Organization Active NPI

Kamlesh D. Nayak, MD, PC

  • Cardiovascular Disease Physician
  • Douglasville, GA
National Provider Identifier
1497815385
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
032003 Issued in GA
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

Updated by the provider on May 30, 2008

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)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
00517283CMedicaidGA

National Provider Directory

National Provider Directory

Locations

8954 Hospital Dr
Ste 125D
Douglasville, GA 30134
Phone (678) 715-8500

Interoperability endpoints

  • FHIR API: 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.

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.

Verify at the official NPI Registry.