Individual provider Active NPI

Avantika Varma, M.D.

  • Family Medicine Physician
  • Marietta, GA
National Provider Identifier
1760825905
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
82481 Issued in GA
Practice address
3472 Winter Wood Way
Marietta, GA 30062-1293
Phone
(404) 595-1697
NPI assigned
Apr 8, 2013
Last updated
Apr 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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 82481 GA Primary

Addresses

Primary practice location

3472 Winter Wood Way
Marietta, GA 30062-1293

Mailing address

650 Ponce de Leon Ave NE Ste 300
Atlanta, GA 30308-1864
Phone (404) 595-1697

Other practice location 1

1650 County Services Pkwy SW Ste 200
Marietta, GA 30008
Phone (770) 514-2806

Other practice location 2

2750 E Beltline NE
Grand Rapids, MI 49503
Phone (616) 267-7015

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
I20190603002819 GA Practitioner - Internal Medicine 4688815749 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Immediate Med of Cobb, P.C. Single Specialty CurrentSince Apr 1, 2019 Accepting new patients
Blossom Q Health, Inc. Family Medicine Current Accepting new patients
Positive Impact Health Centers Inc Single Specialty CurrentSince Nov 1, 2019 Accepting new patients
Positive Impact Health Centers, Inc. CurrentSince Nov 1, 2019 Accepting new patients

Locations

650 Ponce de Leon Ave NE
Ste 300
Atlanta, GA 30308
Phone (404) 493-4412

523 Church St
Decatur, GA 30030
Phone (404) 589-9040

3075 Breckinridge Blvd
Ste 415
Duluth, GA 30096
Phone (770) 962-8396

3350 Breckinridge Blvd
Ste 200
Duluth, GA 30096
Phone (770) 962-8396

2481 George Busbee Pkwy NW
Kennesaw, GA 30144
Phone (770) 423-0000

1650 County Services Pkwy SW
Marietta, GA 30008
Phone (770) 514-2300

1650 County Services Pkwy SW
Ste 200
Marietta, GA 30008
Phone (678) 213-2001

Interoperability endpoints

  • Direct secure messaging: avantika.varma@337577483108356.direct.elationemr.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/6123adb2-d0d2-485a-9dcf-5fba87efb2ef/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1760825905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 PONCE DE LEON AVE NE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303081864",
            "telephone_number": "404-595-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3472 WINTER WOOD WAY",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300621293",
            "telephone_number": "404-595-1697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 County Services Pkwy SW Ste 200",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "30008",
            "country_code": "US",
            "telephone_number": "770-514-2806",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2750 E Beltline NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "49503",
            "country_code": "US",
            "telephone_number": "616-267-7015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARMA",
        "first_name": "AVANTIKA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-08",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "82481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.