Maddineni Holdings LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

055265 Issued in GA

Legal business name

MADDINENI HOLDINGS LLC

Practice address

4485 Tench Rd
Suite No 120
Suwanee, GA 30024-6739

Phone

(770) 932-7605

NPI assigned

Jul 10, 2007

Organization subpart

No

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

Authorized official

Name

Usha Musunuru, M.DNPI 1063445146

Title

Owner

Phone

(770) 932-7605

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• HEALTH STAR FAMILY MEDICINE Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Usha Musunuru, MD

  • Family Medicine Physician
  • Suwanee, GA
  • NPI 1063445146
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300752000000",
    "number": "1497953582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4485 TENCH RD",
            "address_2": "SUITE NO 120",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246739",
            "telephone_number": "770-932-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4485 TENCH RD",
            "address_2": "SUITE NO 120",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246739",
            "telephone_number": "770-932-7605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADDINENI HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2011-03-22",
        "status": "A",
        "authorized_official_last_name": "MUSUNURU",
        "authorized_official_first_name": "USHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-932-7605",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "055265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "511G701213",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NO APPLIED FOR",
            "identifier": "APPLIED FOR",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALTH STAR FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mallory Mabini, RD
• Robert Matthew Maclean, RPH
• John Scott Maddox, LPC
• Pamela Jane Madsen, MS
• Lorien Magnus
• Chalam Mahadevan, M.D.
• Ali Mahony

• Family Medicine Physician in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; 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.