Individual provider Active NPI

Mahith Devathi

  • Clinical Medical Laboratory
  • Lawrenceville, GA
National Provider Identifier
1700755089
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Practice address
1565 Woodington Cir Ste 103
Lawrenceville, GA 30044-2986
Phone
(217) 494-5752
NPI assigned
Nov 4, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1565 Woodington Cir Ste 103
Lawrenceville, GA 30044-2986

Mailing address

1565 Woodington Cir Ste 103
Lawrenceville, GA 30044-2986

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Rapidcare Medical Center Inc Current Accepting new patients
Bsa DME Inc Current Accepting new patients
Summit Clinical Labortary Inc Clinical Medical Laboratory CurrentSince Nov 9, 2025 Accepting new patients
Ship365 Logistics Inc PastSince Nov 9, 2025 Accepting new patients

Locations

1565 Woodington Cir
Ste 103
Lawrenceville, GA 30044
Phone (217) 494-5752

Organizations & group practices 4

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": "1762214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1700755089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 WOODINGTON CIR STE 103",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300442986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 WOODINGTON CIR STE 103",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300442986",
            "telephone_number": "217-494-5752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVATHI",
        "first_name": "MAHITH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-04",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "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 Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.