Active NPI
Sunny Mehta
- Medical Physician Assistant
- Lawrenceville, GA
National Provider Identifier
1700395126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 615 Lawrenceville Suwanee Rd
Lawrenceville, GA 30046-4325 - Phone
- (678) 209-2411
- NPI assigned
- Sep 28, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | Primary |
Addresses
Primary practice location
615 Lawrenceville Suwanee Rd
Lawrenceville, GA 30046-4325
Mailing address
930 Clairidge LN
Lawrenceville, GA 30046-7723
Other practice location 1
311 Gwinnett Dr
Lawrenceville, GA 30046-5671
Phone (770) 910-9196
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1700395126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "930 CLAIRIDGE LN",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300467723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 LAWRENCEVILLE SUWANEE RD",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300464325",
"telephone_number": "678-209-2411"
}
],
"practiceLocations": [
{
"address_1": "311 Gwinnett Dr",
"address_purpose": "LOCATION",
"city": "Lawrenceville",
"state": "GA",
"postal_code": "300465671",
"country_code": "US",
"telephone_number": "770-910-9196",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEHTA",
"first_name": "SUNNY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-28",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.