NPIMap

Individual provider Active NPI

Anitha Koduru, M.D

  • Geriatric Medicine (Internal Medicine) Physician
  • Evans, GA
National Provider Identifier
1689803785
Registry record updated Jul 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
2013016211 Issued in MO
Practice address
447 N Belair Rd Ste 104
Evans, GA 30809
Phone
(706) 854-2180
Fax
(706) 854-2189
NPI assigned
Jul 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2013016211 MO Primary

Addresses

Primary practice location

447 N Belair Rd Ste 104
Evans, GA 30809

Mailing address

PO Box 1705
Augusta, GA 30903-1705
Phone (706) 774-7263

Other practice location 1

3525 S National Ave
207
Springfield, MO 65807-7310
Phone (417) 269-9220

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
I20180831000762 GA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 1153558820 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone (706) 945-0810

660 Cherokee St NE
Suite 100
Marietta, GA 30060-8930
Phone (678) 797-8210

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Professional Services, LLC CurrentSince Jul 21, 2025 Accepting new patients
University Primary Care Current Accepting new patients
University Medical Group LLC CurrentSince Aug 1, 2018 Accepting new patients
University Medical Group LLC CurrentSince Aug 1, 2018 Accepting new patients
Piedmont Medical Care Corporation CurrentSince Sep 1, 2023 Accepting new patients
Piedmont Providers LLC Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

820 Saint Sebastian Way
Ste 4C
Augusta, GA 30901
Phone (706) 774-5997

447 N Belair Rd
Ste 104
Evans, GA 30809
Phone (706) 854-2180

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

925 Branch Ct
Ste 201
Grovetown, GA 30813
Phone (706) 288-3377

660 Cherokee St NE
Ste 100
Marietta, GA 30060
Phone (678) 797-8201

1855 Hudson Bridge Rd
Stockbridge, GA 30281
Phone (678) 565-0648

Organizations & group practices 8

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 6

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": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531094400000",
    "number": "1689803785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1705",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309031705",
            "telephone_number": "706-774-7263",
            "fax_number": "706-774-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 N BELAIR RD STE 104",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "30809",
            "telephone_number": "706-854-2180",
            "fax_number": "706-854-2189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3525 S National Ave",
            "address_2": "207",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658077310",
            "country_code": "US",
            "telephone_number": "417-269-9220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KODURU",
        "first_name": "ANITHA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-09",
        "last_updated": "2018-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "2013016211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

Verify at the official NPI Registry.