Active NPI
Sucheta Panchal, MD
- Family Medicine Physician
- Atlanta, GA
National Provider Identifier
1508876780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 049664
- Practice address
- 868 York Ave SW
Atlanta, GA 30310-2750 - Phone
- (404) 752-1400
- Fax
- (404) 756-8749
- NPI assigned
- Aug 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 049664 | GA | Primary |
Addresses
Primary practice location
868 York Ave SW
Atlanta, GA 30310-2750
Mailing address
868 York Ave SW
Atlanta, GA 30310-2750
Phone (404) 752-1400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 338920115A | Medicaid | GA | |
| 646249666D | Medicaid | GA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 049664 | GA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378166400000",
"number": "1508876780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "868 YORK AVE SW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303102750",
"telephone_number": "404-752-1400",
"fax_number": "404-758-0740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "868 YORK AVE SW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303102750",
"telephone_number": "404-752-1400",
"fax_number": "404-756-8749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANCHAL",
"first_name": "SUCHETA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-09",
"last_updated": "2013-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "049664",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "338920115A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "646249666D",
"state": "GA"
}
],
"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 Sep 3, 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.