Individual provider Active NPI

Sai Kishore Nandamuru, M.D.

  • Psychiatry Physician
  • Columbus, GA
National Provider Identifier
1710983341
Registry record updated Jan 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
041910 Issued in GA
Practice address
3000 Schatulga Rd
Columbus, GA 31907-3117
Phone
(706) 568-6988
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 041910 GA Primary

Addresses

Primary practice location

3000 Schatulga Rd
Columbus, GA 31907-3117

Mailing address

105 Wailea CT
Columbus, GA 31909-8059
Phone (706) 568-6988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091218000047 GA Practitioner - Psychiatry 8628118866 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19806GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Behavioral Health and Developmental Disabilities Current Accepting new patients
Department of Behavioral Health & Developmental Disabilities, Ga CurrentSince Sep 19, 2009 Accepting new patients
Department of Behavioral Health and Developmental Disabilities CurrentSince Sep 19, 2009 Accepting new patients
Georgia Department of Human Resources Past Accepting new patients

Locations

3405 Old Savannah Rd
Augusta, GA 30906
Phone (705) 790-2030

3000 Schatulga Rd
Columbus, GA 31907
Phone (706) 568-5202

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389916800000",
    "number": "1710983341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WAILEA CT",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319098059",
            "telephone_number": "706-568-6988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 SCHATULGA RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319073117",
            "telephone_number": "706-568-6988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANDAMURU",
        "first_name": "SAI",
        "middle_name": "KISHORE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2014-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "041910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.