Kalyani Sukhavasi Ghanta, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

054677 Issued in GA

Practice address

755 Commerce Dr Ste 200
Decatur, GA 30030-2627

Phone

(404) 417-5200

Fax

(404) 417-5204

NPI assigned

Aug 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518072198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 COMMERCE DR STE 200",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302627",
            "telephone_number": "404-417-5200",
            "fax_number": "404-417-5204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 COMMERCE DR STE 200",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302627",
            "telephone_number": "404-417-5200",
            "fax_number": "404-417-5204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHANTA",
        "first_name": "KALYANI",
        "middle_name": "SUKHAVASI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "054677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keyonia Germon, LPN
• Margaret R Geronimo, LCSW, LMFT
• Asres Orit Getanek
• Lunye Geter, CAC1
• Mehrnoosh Ghandili, MD
• Summer Denise Gholston
• Shahzad Ghori, D.P.M.
• Ghulam Ghous, M.D
• James Giannakakis, PA-C
• Paula Gibbons, RN

• Internal Medicine Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.