NPIMap

Individual provider Active NPI

Sudhakara Babu Chennareddy, MD

  • Cardiovascular Disease Physician
  • Gainesville, GA
National Provider Identifier
1679572069
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
079242 Issued in GA
Practice address
200 S Enota Dr NE Ste 100
Gainesville, GA 30501-3466
Phone
(770) 534-2020
Fax
(770) 534-8025
NPI assigned
Jul 18, 2005
Last updated
Dec 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 079242 GA Primary

Addresses

Primary practice location

200 S Enota Dr NE Ste 100
Gainesville, GA 30501-3466

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other identifiers 1

IdentifierTypeStateIssuer
64036478MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address schennareddy90374@nghs.gadirect.net Direct

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
I20180725004016 GA Practitioner - Cardiovascular Disease (Cardiology) 2769537851 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Heart Institute LLCGroup PAC ID 4183848062, 127 clinicians

Practice addresses (Care Compare)

200 S Enota Dr NE
Suite 200
Gainesville, GA 30501-3466
Phone (770) 534-2020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.46 of 100Reported as group
Quality
85.33
Promoting interoperability
100
Improvement activities
40
Cost
76.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
079242GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology of Kentucky Cardiovascular Disease CurrentSince Jul 16, 2001 Accepting new patients
Northeast Georgia Medical Center, Inc. CurrentSince Jan 22, 2022 Accepting new patients
Georgia Heart Institute LLC Cardiovascular Disease CurrentSince Mar 1, 2018 Accepting new patients
Northeast Georgia Heart Center Cardiovascular Disease Current Accepting new patients
Northeast Georgia Medical Center, Inc. Current Accepting new patients

Locations

200 S Enota Dr NE
Ste 100
Gainesville, GA 30501
Phone (770) 219-0950

200 S Enota Dr NE
Ste 200
Gainesville, GA 30501
Phone (770) 534-0991

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

4003 Kresge Way
Ste 221
Louisville, KY 40207
Phone (502) 894-9499

Interoperability endpoints

  • Direct secure messaging: schennareddy90374@nghs.gadirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1679572069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S ENOTA DR NE STE 100",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013466",
            "telephone_number": "770-534-2020",
            "fax_number": "770-534-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENNAREDDY",
        "first_name": "SUDHAKARA",
        "middle_name": "BABU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "079242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64036478",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "schennareddy90374@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "200 S Enota Dr NE Ste 100",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.