Active NPI
Amrutha Nataraj, M.D
- Pediatrics Physician
- Fort Gordon, GA
National Provider Identifier
1770674178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 024609
- Practice address
- 300 E. Hospital Road
Family Practice Clinic
Fort Gordon, GA 30905-5650 - Phone
- (706) 787-9252
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 024609 | GA | Primary |
Addresses
Primary practice location
300 E. Hospital Road
Family Practice Clinic
Fort Gordon, GA 30905-5650
Mailing address
300 Hospital Road
Family Practice Clinic
Fort Gordon, GA 30905-5650
Phone (706) 787-9252
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130502000261 | GA | Order and Referring Only - Pediatric Medicine | 6406093822 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024609 | GA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381276800000",
"number": "1770674178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 HOSPITAL ROAD",
"address_2": "FAMILY PRACTICE CLINIC",
"city": "FORT GORDON",
"state": "GA",
"postal_code": "309055650",
"telephone_number": "706-787-9252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 E. HOSPITAL ROAD",
"address_2": "FAMILY PRACTICE CLINIC",
"city": "FORT GORDON",
"state": "GA",
"postal_code": "309055650",
"telephone_number": "706-787-9252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NATARAJ",
"first_name": "AMRUTHA",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2013-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "024609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Gordon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.