Individual provider Active NPI

Rajeshkumar Motilal Miniyar, M.D.

  • Pediatrics Physician
  • Dalton, GA
National Provider Identifier
1790706596
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
051597 Issued in GA
Practice address
711 Shields Rd
Dalton, GA 30720-5013
Phone
(706) 278-6628
Fax
(706) 278-6650
NPI assigned
Jul 21, 2006
Last updated
Sep 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 051597 GA Primary

Addresses

Primary practice location

711 Shields Rd
Dalton, GA 30720-5013

Mailing address

140 Three Rivers Dr NE
Rome, GA 30161-4999
Phone (706) 232-1300

Other identifiers 2

IdentifierTypeStateIssuer
000954346BMedicaidGA
299653708AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
051597GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Miniyars Pediatrics, P.C. Pediatrics Past Accepting new patients

Organizations & group practices 1

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1790706596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 THREE RIVERS DR NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301614999",
            "telephone_number": "706-232-1300",
            "fax_number": "706-232-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 SHIELDS RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307205013",
            "telephone_number": "706-278-6628",
            "fax_number": "706-278-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINIYAR",
        "first_name": "RAJESHKUMAR",
        "middle_name": "MOTILAL",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "051597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000954346B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "299653708A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; 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.