Individual provider Active NPI

Danielle Kuthuru, CRNP

  • Family Nurse Practitioner
  • Sandy Springs, GA
National Provider Identifier
1780454249
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP713411 Issued in GA
Practice address
1100 Johnson Fy Rd NE
Sandy Springs, GA 30342-1709
Phone
(404) 843-4182
NPI assigned
Jan 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-NP713411 GA Primary

Addresses

Primary practice location

1100 Johnson Fy Rd NE
Sandy Springs, GA 30342-1709

Mailing address

1100 Johnson Fy Rd NE
Sandy Springs, GA 30342-1709
Phone (404) 843-4182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240430004313 MD Practitioner - Nurse Practitioner 5991145443 Reassigns benefits to 1 organization
I20260417003072 GA Practitioner - Nurse Practitioner 5991145443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Drexel University College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

631 Professional Dr
Suite 210
Lawrenceville, GA 30046-3392
Phone (404) 851-6284

Hospital & facility affiliations

  • Mercy Medical Center Inc Hospital, Baltimore, MD, CCN 210008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
GAA-NP002793GAMDFamily Nurse Practitioner
R214543MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Paul Place Specialists Inc CurrentSince Apr 11, 2024 Accepting new patients
St. Paul Place Specialists, Inc. Current Accepting new patients
St Paul Place Specialists, Inc. CurrentSince Apr 11, 2024 Accepting new patients

Locations

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1780454249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FY RD NE",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303421709",
            "telephone_number": "404-843-4182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FY RD NE",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303421709",
            "telephone_number": "404-843-4182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTHURU",
        "first_name": "DANIELLE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-05",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP713411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy Springs, GA

Sources for this page

Verify at the official NPI Registry.