Blossom Q Health, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BLOSSOM Q HEALTH, INC.

Doing business as

Equal Health

Practice address

2133 Boyce Cir
Marietta, GA 30066-4514

Phone

(404) 595-1697

NPI assigned

May 2, 2023

Last updated

May 2, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Avantika Varma, MDNPI 1760825905

Title

Ceo

Phone

(404) 595-1697

Specialties & licenses 2

Addresses

Other names 1

• Equal Health Doing business as

Practitioners 1

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.

• Avantika Varma, M.D.

  • Family Medicine Physician
  • Marietta, GA
  • NPI 1760825905
  NPD Authorized official

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1780373290",
    "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": "2133 BOYCE CIR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300664514",
            "telephone_number": "404-595-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM Q HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "VARMA",
        "authorized_official_first_name": "AVANTIKA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-595-1697",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Equal Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; 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.