NPIMap

Individual provider Active NPI

Dinakara B. Shetty, MD

  • Internal Medicine Physician
  • Warner Robins, GA
National Provider Identifier
1619914975
Registry record updated Jul 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
042431 Issued in GA
Practice address
1719 Russell Pkwy
BLDG 700
Warner Robins, GA 31088-5763
Phone
(478) 328-0806
Fax
(478) 328-1393
NPI assigned
Jun 2, 2006
Last updated
Jul 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 042431 GA Primary

Addresses

Primary practice location

1719 Russell Pkwy
BLDG 700
Warner Robins, GA 31088-5763

Mailing address

1719 Russell Pkwy
Building #700
Warner Robins, GA 31088-5763
Phone (478) 328-0806

Other identifiers 1

IdentifierTypeStateIssuer
00720948LMedicaidGA

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
I20040128000639 GA Practitioner - Internal Medicine 1557264553 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeast Medical Group, P.C.Group PAC ID 3577559673, 139 clinicians
Houston Hospitals IncGroup PAC ID 4284797580, 27 clinicians

Practice addresses (Care Compare)

1255 Friendship Rd
Suite 130
Braselton, GA 30517-5617
Phone (770) 442-1911

1601 Watson Blvd
Warner Robins, GA 31093-3431
Phone (478) 922-4281

1719 Russell Pkwy
Warner Robins, GA 31088-5763
Phone (770) 442-1911

701 Bluebird Blvd
Fort Valley, GA 31030-5085
Phone (478) 328-7674

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042431GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brown Family Practice, LLC Current Accepting new patients
Southeast Medical Group, P.C. CurrentSince Nov 1, 2022 Accepting new patients
Houston Hospitals Inc CurrentSince Jan 1, 2009 Accepting new patients
Houston Hospitals Inc CurrentSince Jan 1, 2009 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
UC Docs, PC Past Accepting new patients

Locations

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

218 GA Highway 49 N
Byron, GA 31008
Phone (478) 956-2388

406 Central Dr
East Dublin, GA 31027
Phone (478) 275-1122

701 N Camellia Blvd
Fort Valley, GA 31030
Phone (478) 825-0023

4300 Northpoint Pkwy
Ste 300
Johns Creek, GA 30022
Phone (770) 518-4406

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

1601 Watson Blvd
Ste 140B
Warner Robins, GA 31093
Phone (478) 922-4281

1719 Russell Pkwy
Warner Robins, GA 31088
Phone (478) 328-7674

1719 Russell Pkwy
Ste 700
Warner Robins, GA 31088
Phone (478) 328-0806

2054 Watson Blvd
Warner Robins, GA 31093
Phone (478) 918-0770

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61037
  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

Organizations & group practices 7

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 10

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216598400000",
    "number": "1619914975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 RUSSELL PKWY",
            "address_2": "BUILDING #700",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310885763",
            "telephone_number": "478-328-0806",
            "fax_number": "478-328-1393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 RUSSELL PKWY",
            "address_2": "BLDG 700",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310885763",
            "telephone_number": "478-328-0806",
            "fax_number": "478-328-1393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "DINAKARA",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2008-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "042431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00720948L",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.