Ssa Tele LLC

Primary specialty

Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X

Legal business name

SSA TELE LLC

Practice address

2264 Moondance LN
Marietta, GA 30062-2890

Phone

(856) 296-0946

NPI assigned

May 5, 2021

Last updated

Aug 18, 2021By 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

Shirish Amrutia, MDNPI 1659531747

Title

Organizer

Phone

(516) 665-1883

Specialties & licenses 2

Addresses

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.

• Shirish Amrutia, M.D.

  • Pulmonary Disease Physician
  • Canton, GA
  • NPI 1659531747
  Authorized official Same address or phone

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1821672965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2264 MOONDANCE LN",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300622890",
            "telephone_number": "856-296-0946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2264 MOONDANCE LN",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300622890",
            "telephone_number": "856-296-0946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSA TELE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "AMRUTIA",
        "authorized_official_first_name": "SHIRISH",
        "authorized_official_title_or_position": "ORGANIZER",
        "authorized_official_telephone_number": "516-665-1883",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jalisa L Spy
• Makayla Square, RBT
• Brittany Squires, MSW
• Arpita Srivastava, M.D.
• Bridget M Sroka, PA-C
• Kenette St-Gourdin, MD
• Stacy Bennett, Speech Language Pathologist, LLC
• Wilkie J Stadeker, DDS
• Madeline Stafford
• Josiah Staggers

• Sleep Medicine (Internal Medicine) Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Sleep Medicine (Internal Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.