Krishna V Gumidyala, MD

Key facts

NPI

1649486994

Entity type

Individual (NPI type 1)

Primary specialty

Orthopaedic Surgery of the Spine Physician 207XS0117X

License

.064382 (GA)

Practice address

5667 Peachtree Dunwoody Rd Ste 220
Atlanta, GA 30342-1725

Phone

(404) 252-2422

Fax

(404) 252-6223

NPI assigned

May 15, 2007

Sex

Male

Sole proprietor

No

Organizations & group practices 5

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.

• Carrollton Orthopaedic Clinic PC Rheumatology Physician · Carrollton, GA · NPI 1356483747
  Medicare reassignment Care Compare group NPD GA · ORTHOPAEDIC SURGERY
• Wellstar Medical Group, LLC Family Medicine Physician · Kennesaw, GA · NPI 1558664003
  Medicare reassignment NPD GA
• Wellstar Medical Group, LLC Multi-Specialty Clinic/Center · Marietta, GA · NPI 1275992240
  NPD
• Wellstar Medical Group, LLC Family Medicine Physician · Austell, GA · NPI 1295031839
  NPD
• Mayo Clinic Health System in Waycross, Inc. Multi-Specialty Clinic/Center · Waycross, GA · NPI 1154745982
  NPD (past)

Hospital & facility affiliations 4

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

• Amedisys Georgia, LLC Home Health Agency · Douglasville, GA · NPI 1437117090
  Care Compare affiliation Home health agency
• Tanner Medical Center, Inc General Acute Care Hospital · Carrollton, GA · NPI 1801883780
  Care Compare affiliation Hospital
• TMC Home Health Inc Home Health Agency · Carrollton, GA · NPI 1457376386
  Care Compare affiliation Home health agency
• TMC/Villa Rica Hospital, Inc General Acute Care Hospital · Villa Rica, GA · NPI 1851388748
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Orthopedic Surgery

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carrollton Orthopaedic Clinic PC (31 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tanner Home Health Services Home health agency · Carrollton, GA · CCN 117319
• Central Home Health Care, an Amedisys Company Home health agency · Douglasville, GA · CCN 117050
• Tanner Medical Center - Carrollton Hospital · Carrollton, GA · CCN 110011
• Tanner Medical Center Villa Rica Hospital · Villa Rica, GA · CCN 110015

Procedures performed for Medicare patients

Medicare participation

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kgumidyala71101@directwellstar.org
• Direct secure messaging: krishna.gumidyala@po.eclinicaldirectplus.com

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 6, 2023.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1649486994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5667 PEACHTREE DUNWOODY RD STE 220",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421725",
            "telephone_number": "404-252-2422",
            "fax_number": "404-252-6223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5667 PEACHTREE DUNWOODY RD STE 220",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421725",
            "telephone_number": "404-252-2422",
            "fax_number": "404-252-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMIDYALA",
        "first_name": "KRISHNA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2023-02-06",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "064382",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "GA",
            "license": ".064382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Atlanta, GA · Orthopaedic Surgery of the Spine Physician in Georgia