Individual provider Active NPI

Nimra Choudhry, DO

  • Family Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1588243166
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
103421 Issued in GA
Practice address
665 Duluth Hwy Ste 401
Lawrenceville, GA 30046-4303
Phone
(914) 826-5184
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 103421 GA Primary

Addresses

Primary practice location

665 Duluth Hwy Ste 401
Lawrenceville, GA 30046-4303

Mailing address

PO Box 1190
Lawrenceville, GA 30046-1190
Phone (914) 826-5184

Other practice location 1

1575 Mount Vernon Rd
Dunwoody, GA 30338-4146
Phone (404) 996-0197

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
I20250814002785 GA Practitioner - Family Practice 7719389378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

2450 Old Milton Pkwy
Alpharetta, GA 30009-2520

3747 Roswell Rd
Marietta, GA 30062-6227

3980 Jiles Rd NW
Kennesaw, GA 30144-1109
Phone (678) 504-0100

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

780 Church St NE
Marietta, GA 30060-7269

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103421GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Aug 1, 2025 Accepting new patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

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 3

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": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1588243166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1190",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300461190",
            "telephone_number": "914-826-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 DULUTH HWY STE 401",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464303",
            "telephone_number": "914-826-5184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1575 Mount Vernon Rd",
            "address_purpose": "LOCATION",
            "city": "Dunwoody",
            "state": "GA",
            "postal_code": "303384146",
            "country_code": "US",
            "telephone_number": "404-996-0197",
            "fax_number": "770-730-9969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOUDHRY",
        "first_name": "NIMRA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "103421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.