Organization Active NPI

Linduc PC

  • Internal Medicine Physician
  • Decatur, GA
National Provider Identifier
1750934857
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LINDUC PC
Practice address
2680 Lawrenceville Hwy Ste 202
Decatur, GA 30033-2526
Phone
(470) 250-1418
Fax
(770) 674-7626
NPI assigned
Jul 18, 2019
Last updated
May 15, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
LINDUC PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Authorized official

Name
Uchenna Peter Kalu, MDNPI 1841312907
Title
Medical Director
Phone
(470) 250-1418

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU

Addresses

Primary practice location

2680 Lawrenceville Hwy Ste 202
Decatur, GA 30033-2526

Mailing address

2680 Lawrenceville Hwy Ste 202
Decatur, GA 30033-2526
Phone (470) 250-1418

Other identifiers 1

IdentifierTypeStateIssuer
734200366CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110712000394 GA Part B Supplier - Clinic/Group Practice 6305014614 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Decatur, GA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Linduc PC2 organizations share this tax ID, including this one
Part of
Linduc PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1750934857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 LAWRENCEVILLE HWY STE 202",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332526",
            "telephone_number": "470-250-1418",
            "fax_number": "770-674-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 LAWRENCEVILLE HWY STE 202",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332526",
            "telephone_number": "470-250-1418",
            "fax_number": "770-674-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDUC PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LINDUC PC",
        "enumeration_date": "2019-07-18",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "KALU",
        "authorized_official_first_name": "UCHENNA",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "470-250-1418",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "734200366C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.