Individual provider Active NPI

Charishma Nayyar, P.A.

  • Surgical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1497934129
Registry record updated Jun 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
6654 Issued in GA
Practice address
975 Johnson Ferry Rd NE
Suite 100
Atlanta, GA 30342-1618
Phone
(404) 256-1311
Fax
(404) 705-2774
NPI assigned
Oct 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 012074 NY
Surgical Physician Assistant 363AS0400X 6654 GA Primary

Addresses

Primary practice location

975 Johnson Ferry Rd NE
Suite 100
Atlanta, GA 30342-1618

Mailing address

975 Johnson Ferry Rd NE
Suite 100
Atlanta, GA 30342-1618
Phone (404) 256-1311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6654GAMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370563200000",
    "number": "1497934129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 JOHNSON FERRY RD NE",
            "address_2": "SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421618",
            "telephone_number": "404-256-1311",
            "fax_number": "404-705-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 JOHNSON FERRY RD NE",
            "address_2": "SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421618",
            "telephone_number": "404-256-1311",
            "fax_number": "404-705-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAYYAR",
        "first_name": "CHARISHMA",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-30",
        "last_updated": "2013-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "012074",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "6654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; 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.