NPIMap

Individual provider Active NPI

Viktoria Nurpeisov, MD

  • Family Medicine Physician
  • Smyrna, GA
National Provider Identifier
1699923169
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
64686 Issued in GA
Practice address
582 Concord Rd SE
Smyrna, GA 30082-2616
Phone
(470) 956-4000
Fax
(770) 319-5703
NPI assigned
Sep 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 64686 GA Primary

Addresses

Primary practice location

582 Concord Rd SE
Smyrna, GA 30082-2616

Mailing address

582 Concord Rd SE
Smyrna, GA 30082-2616
Phone (470) 956-4000

Other identifiers 1

IdentifierTypeStateIssuer
58-2329008MedicaidGA

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
I20101204000020 GA Practitioner - Emergency MedicinePractitioner - Family Practice 4981890951 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
Medical College of Georgia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southland Emergency Medical Services Consolidated, LLCGroup PAC ID 4183871320, 48 clinicians
Southland Cochran Emergency Medical Services LLCGroup PAC ID 9638398027, 17 clinicians
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

145 E Peacock St
Cochran, GA 31014-7846
Phone (229) 200-4950

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

582 Concord Rd SE
Smyrna, GA 30082-2616
Phone (470) 644-0167

Hospital & facility affiliations

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
64686GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients
Wellstar Medical Group, LLC Family Medicine CurrentSince Apr 1, 2016 Accepting new patients
Southland Cochran Emergency Medical Services, LLC CurrentSince Jul 1, 2014 Accepting new patients
Southland Emergency Medical Services Consolidated, LLC Family Medicine CurrentSince Jul 7, 2014 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2016 Accepting new patients
Bleckley Physician Services LLC Past Accepting new patients
Bleckley Emergency Group LLC Past Accepting new patients
A. G. Rhodes Home, Cobb Inc. Past Accepting new patients

Locations

303 Parkway Dr NE
Atlanta, GA 30312
Phone (404) 265-4000

145 E Peacock St
Cochran, GA 31014
Phone (229) 200-4950

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

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

1000 Corporate Center Dr
Ste 200
Morrow, GA 30260
Phone (770) 968-6464

1221 E McPherson Ave
Nashville, GA 31639
Phone (229) 543-7100

610 Sparta Rd
Sandersville, GA 31082
Phone (478) 240-2000

582 Concord Rd SE
Smyrna, GA 30082
Phone (470) 956-4000

Interoperability endpoints

  • Direct secure messaging: vnurpeisov123253@directwellstar.org
  • Direct secure messaging: viktoriya.nurpeisov.p52@direct.tenet.nextgenshare.com

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 11

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": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699923169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 CONCORD RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300822616",
            "telephone_number": "470-956-4000",
            "fax_number": "770-319-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 CONCORD RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300822616",
            "telephone_number": "470-956-4000",
            "fax_number": "770-319-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NURPEISOV",
        "first_name": "VIKTORIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "64686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58-2329008",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

Verify at the official NPI Registry.