Individual provider Active NPI

Santhi P Chennareddy, MD

  • Internal Medicine Physician
  • Gainesville, GA
National Provider Identifier
1568413060
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
82141 Issued in GA
Practice address
1240 Jesse Jewell Pkwy SE Ste 500
Gainesville, GA 30501-3861
Phone
(770) 536-9864
Fax
(770) 297-5023
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01061425A IN
Internal Medicine Physician 207R00000X 82141 GA Primary

Addresses

Primary practice location

1240 Jesse Jewell Pkwy SE Ste 500
Gainesville, GA 30501-3861

Mailing address

5300 State Road 64
Suite 101
Georgetown, IL 60686-0038
Phone (812) 949-5482

Other practice location 1

5300 State Road 64
Suite 101
Georgetown, IN 47122-9178
Phone (812) 923-4200

Other identifiers 3

IdentifierTypeStateIssuer
P00306208OtherINRR MEDICARE
000000387032OtherANTHEM BCBS
200803790MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address santhichennareddy@negaidx.allscripts.net Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191023003728 GA Practitioner - Internal Medicine 2264456185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1000 Johnson Ferry Rd
Atlanta, GA 30342-1611

1001 Summit Blvd
Suite 1000
Brookhaven, GA 30319-6408

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.26 of 100Reported as group
Quality
71.9
Promoting interoperability
75
Improvement activities
40
Cost
76.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01061425AINMDFamily Medicine Physician
82141GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Diagnostic Associates and Clinic, LLC CurrentSince Sep 10, 2019 Accepting new patients
FMMG LLC Family Medicine Past Accepting new patients

Locations

1270 Friendship Rd
Ste 100
Braselton, GA 30517
Phone (470) 228-7900

1250 Jesse Jewell Pkwy SE
Ste 400
Gainesville, GA 30501
Phone (470) 228-7507

1240 Jesse Jewell Pkwy SE
Ste 500
Gainesville, GA 30501

Interoperability endpoints

  • Direct secure messaging: santhichennareddy@negaidx.allscriptsdirect.net

Organizations & group practices 2

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

Hospital & facility affiliations 2

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1568413060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 STATE ROAD 64",
            "address_2": "SUITE 101",
            "city": "GEORGETOWN",
            "state": "IL",
            "postal_code": "606860038",
            "telephone_number": "812-949-5482",
            "fax_number": "812-949-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE STE 500",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013861",
            "telephone_number": "770-536-9864",
            "fax_number": "770-297-5023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5300 State Road 64",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "IN",
            "postal_code": "471229178",
            "country_code": "US",
            "telephone_number": "812-923-4200",
            "fax_number": "812-923-4207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHENNAREDDY",
        "first_name": "SANTHI",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01061425A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "82141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00306208",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000387032",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200803790",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "santhichennareddy@negaidx.allscripts.net",
            "affiliation": "N",
            "endpointDescription": "direct messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct edge",
            "address_1": "1240 Jesse Jewell Pkwy SE Ste 500",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.