Organization Active NPI

Arun a. Pol, MD, PC

  • Psychiatry Physician
  • Duluth, GA
National Provider Identifier
1497818124
Registry record updated Nov 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
039907 Issued in GA
Legal business name
ARUN A. POL, MD, PC
Practice address
6290 Abbotts Bridge Rd
Suite 502
Duluth, GA 30097-8495
Phone
(770) 623-8830
Fax
(770) 623-8846
NPI assigned
Dec 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2013

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

Authorized official

Name
Dr. Arun Anandrao Pol, MDNPI 1205015534
Title
President
Phone
(770) 623-8830

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 039907 GA Primary

Addresses

Primary practice location

6290 Abbotts Bridge Rd
Suite 502
Duluth, GA 30097-8495

Mailing address

6290 Abbotts Bridge Rd
Suite 502
Duluth, GA 30097-8495
Phone (770) 623-8830

Other identifiers 1

IdentifierTypeStateIssuer
000825712AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080429000600 GA Part B Supplier - Clinic/Group Practice 3173602364 Receives reassigned benefits from 1 practitioner
Practice locations: Johns Creek, GA

National Provider Directory

National Provider Directory

Locations

6290 Abbotts Bridge Rd
Ste 502
Johns Creek, GA 30097
Phone (770) 623-8830

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": "1166313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384646400000",
    "number": "1497818124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6290 ABBOTTS BRIDGE RD",
            "address_2": "SUITE 502",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978495",
            "telephone_number": "770-623-8830",
            "fax_number": "770-623-8846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6290 ABBOTTS BRIDGE RD",
            "address_2": "SUITE 502",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978495",
            "telephone_number": "770-623-8830",
            "fax_number": "770-623-8846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARUN A. POL, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-17",
        "last_updated": "2013-11-17",
        "status": "A",
        "authorized_official_last_name": "POL",
        "authorized_official_first_name": "ARUN",
        "authorized_official_middle_name": "ANANDRAO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-623-8830",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "039907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000825712A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2013; 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.