Individual provider Active NPI

Kavitha Vemuri, MD

  • Internal Medicine Physician
  • Macon, GA
National Provider Identifier
1790849495
Registry record updated Feb 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
055350 Issued in GA
Practice address
6501 Peake Rd
Suite 700
Macon, GA 31210-8042
Phone
(478) 476-9285
Fax
(478) 474-9034
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 055350 GA Primary

Addresses

Primary practice location

6501 Peake Rd
Suite 700
Macon, GA 31210-8042

Mailing address

5410 Maryland Way
Suite 300
Brentwood, TN 37027-5064
Phone (615) 377-5670

Other identifiers 1

IdentifierTypeStateIssuer
622559586AMedicaidGA

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
I20041007000368 GA Practitioner - Internal Medicine 7911966700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cogent Healthcare of Georgia PCGroup PAC ID 2961483607, 252 clinicians

Practice addresses (Care Compare)

1170 Cleveland Ave
East Point, GA 30344-3615
Phone (404) 466-1170

350 Hospital Dr
Macon, GA 31217-3838
Phone (478) 721-0200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
055350GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients
Hospital Specialists, PC Internal Medicine Past Accepting new patients
Coliseum Medical Center, LLC Past Accepting new patients
Hospital Specialists of Dublin, PC Internal Medicine Past Accepting new patients

Locations

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296604800000",
    "number": "1790849495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 MARYLAND WAY",
            "address_2": "SUITE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275064",
            "telephone_number": "615-377-5670",
            "fax_number": "615-377-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 PEAKE RD",
            "address_2": "SUITE 700",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312108042",
            "telephone_number": "478-476-9285",
            "fax_number": "478-474-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEMURI",
        "first_name": "KAVITHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2011-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "055350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "622559586A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.