Individual provider Active NPI

Kannan M Narayana, MD

  • Neuro-ophthalmology Physician
  • Gainesville, GA
National Provider Identifier
1629220512
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuro-ophthalmology PhysicianTaxonomy code 207WX0109X
License
73923 Issued in GA
Practice address
1240 Jesse Jewell Pkwy SE Ste 400
Gainesville, GA 30501-3861
Phone
(770) 534-1117
Fax
(770) 503-7285
NPI assigned
Oct 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 73923 GA
Neurology Physician 2084N0400X 73923 GA
Neuro-ophthalmology Physician 207WX0109X 73923 GA Primary

Addresses

Primary practice location

1240 Jesse Jewell Pkwy SE Ste 400
Gainesville, GA 30501-3861

Mailing address

1240 Jesse Jewell Pkwy SE Ste 400
Gainesville, GA 30501-3861
Phone (770) 534-1117

Other practice location 1

1120 15th Street
Augusta, GA 30912-0004
Phone (706) 721-8623

Other practice location 2

550 Peachtree St NE
Suite 1850, EMORY MOT building
Atlanta, GA 30308-2208
Phone (404) 778-2020

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
I20150708000391 GA Practitioner - OphthalmologyPractitioner - Neurology 1254643026 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Neurology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians
Northeast Georgia Diagnostic Associates and Clinic, LLCGroup PAC ID 1951655737, 81 clinicians

Practice addresses (Care Compare)

1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-8623

1240 Jesse Fewell Pkwy SE
Suite 500
Gainesville, GA 30501-3861
Phone (770) 536-9864

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

989 Saint Sebastian Way
Augusta, GA 30912-0004
Phone (706) 721-2171

Hospital & facility affiliations

  • Wellstar MCG Health, Affiliated With Med Col Hospital, Augusta, GA, CCN 110034
  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
73923GAMDNeuro-ophthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Diagnostic Associates and Clinic, LLC CurrentSince Jan 1, 2025 Accepting new patients
Au Medical Associates Inc CurrentSince Mar 1, 2024 Accepting new patients
Northside Primary Care Professional Services, LLC CurrentSince Apr 8, 2020 Accepting new patients
Northside Primary Care Professional Services,LLC CurrentSince Apr 8, 2020 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Au Medical Associates Inc CurrentSince Mar 1, 2024 Accepting new patients
Wellstar Medical Group, LLC CurrentSince May 1, 2024 Accepting new patients
The Emory Clinic Pediatric Providers Past Accepting new patients
Northeast Georgia Diagnostic Clinic LLC Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

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

1240 Jesse Jewell Pkwy SE
Ste 500
Gainesville, GA 30501

1240 Jesse Jewell Pkwy SE
Ste 400
Gainesville, GA 30501
Phone (770) 297-1106

1240 Jesse Jewell Pkwy SE
Ste 600
Gainesville, GA 30501
Phone (770) 287-0031

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

1285 Upper Hembree Rd
Ste 205
Roswell, GA 30076
Phone (770) 521-1587

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

Interoperability endpoints

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

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1629220512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE STE 400",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013861",
            "telephone_number": "770-534-1117",
            "fax_number": "770-503-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE STE 400",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013861",
            "telephone_number": "770-534-1117",
            "fax_number": "770-503-7285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 15th Street",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309120004",
            "country_code": "US",
            "telephone_number": "706-721-8623",
            "fax_number": "706-721-1459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 Peachtree St NE",
            "address_2": "Suite 1850, EMORY MOT building",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303082208",
            "country_code": "US",
            "telephone_number": "404-778-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NARAYANA",
        "first_name": "KANNAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-22",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "73923",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "73923",
            "primary": false
        },
        {
            "code": "207WX0109X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Neuro-ophthalmology",
            "state": "GA",
            "license": "73923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.