NPIMap

Individual provider Active NPI

Lakshman Kumar Dinavahi, MD

  • Internal Medicine Physician
  • Marietta, GA
National Provider Identifier
1528233723
Registry record updated Feb 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
70088 Issued in GA
Practice address
3505 Lassiter Falls Dr NE
Marietta, GA 30062-4199
Phone
(414) 916-9031
NPI assigned
Apr 28, 2008
Last updated
Feb 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 70088 GA
Internal Medicine Physician 207R00000X 70088 GA Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 70088 GA
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 52384-20 WI
Internal Medicine Physician 207R00000X 52384-20 WI

Addresses

Primary practice location

3505 Lassiter Falls Dr NE
Marietta, GA 30062-4199

Mailing address

3505 Lassiter Falls Dr NE
Marietta, GA 30062-4199
Phone (414) 916-9031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130820000875 GA Practitioner - Internal Medicine 5799836243 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

110 Cherokee PL
Cartersville, GA 30121-2954
Phone (770) 386-6300

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-2129
Phone (404) 217-9818

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
52384-20WIMDGeriatric Medicine (Internal Medicine) Physician
70088GAMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anemonefish Inpatient Services LLC Internal Medicine CurrentSince Aug 1, 2021 Accepting new patients
MD Wellness Clinic LLC Current Accepting new patients
Allatoona Physician Services PC CurrentSince Aug 29, 2022 Accepting new patients
Homestead Hospice of Cartersville, LLC CurrentSince Aug 25, 2022 Accepting new patients
V Physician Services LLC Internal Medicine CurrentSince Oct 1, 2021 Accepting new patients
Blue Summit Palliative Care LLC CurrentSince Oct 1, 2024 Accepting new patients
Indian Mounds Inpatient Services LLC Past Accepting new patients
Mount Lassen Emergency Physicians LLC Past Accepting new patients

Locations

100 Market Place Blvd
Ste 301
Cartersville, GA 30121
Phone (678) 290-4817

1124 N Tennessee St
Ste 104
Cartersville, GA 30120
Phone (470) 684-1448

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (404) 554-2196

5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340

11113 Houze Rd
Ste 150
Roswell, GA 30076
Phone (470) 365-2657

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GHIICD
  • FHIR API: https://fhir4.healow.com/fhir/r4/GHIICD/Endpoint/GHIICD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Blue Summit Hospice of RoswellRoswell, GA, CCN 851578 Hospice Contracted Managing Employee Jan 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706918400000",
    "number": "1528233723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 LASSITER FALLS DR NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300624199",
            "telephone_number": "414-916-9031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 LASSITER FALLS DR NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300624199",
            "telephone_number": "414-916-9031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINAVAHI",
        "first_name": "LAKSHMAN",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-28",
        "last_updated": "2024-02-03",
        "certification_date": "2024-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "GA",
            "license": "70088",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "70088",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "70088",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WI",
            "license": "52384-20",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "52384-20",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.