Individual provider Active NPI

Vedant Gupta, D.O

  • Hospitalist Physician
  • Atlanta, GA
National Provider Identifier
1679967780
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
943311 Issued in GA
Practice address
1405 Clifton Rd NE # Tower2
Atlanta, GA 30322-1060
Phone
(706) 414-7198
NPI assigned
Mar 26, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34.012931 OH
Hospitalist Physician 208M00000X 007957 AZ
Hospitalist Physician 208M00000X 943311 GA Primary

Addresses

Primary practice location

1405 Clifton Rd NE # Tower2
Atlanta, GA 30322-1060

Mailing address

1405 Clifton Rd NE # Tower2
Atlanta, GA 30322-1060
Phone (706) 414-7198

Other practice location 1

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0777

Other identifiers 1

IdentifierTypeStateIssuer
572001MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210406001798 AZ Practitioner - Hospitalist 4183971989 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.012931OHMDPediatrics Physician
943311GAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Apr 1, 2021 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Apr 1, 2021 Accepting new patients
Phoenix Children'S Hospital Pediatrics Current Accepting new patients
Arthur M. Blank Hospital, Inc. Past Accepting new patients
Scottish Rite Childrens Medical Ctr Past Accepting new patients
Egleston Children'S Hospital at Emory University, Inc. Past Accepting new patients

Locations

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1679967780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE # TOWER2",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221060",
            "telephone_number": "706-414-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE # TOWER2",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221060",
            "telephone_number": "706-414-7198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 E Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850167710",
            "country_code": "US",
            "telephone_number": "602-933-0777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "VEDANT",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34.012931",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "007957",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "943311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "572001",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.