Organization Active NPI

Ajay M Kothari MD LLC

  • Neurology Physician
  • Americus, GA
National Provider Identifier
1831445634
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
26984 Issued in GA
Legal business name
AJAY M KOTHARI MD LLC
Practice address
136 S Lee St Ste a
Americus, GA 31709-3698
Phone
(229) 380-0266
Fax
(229) 380-0267
NPI assigned
Jul 30, 2012
Last updated
Oct 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Authorized official

Name
Dr. Ajay Maheshchandra Kothari, M.DNPI 1568473551
Title
Physician
Phone
(229) 942-9534

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 26984 GA Primary

Addresses

Primary practice location

136 S Lee St Ste a
Americus, GA 31709-3698

Mailing address

109 Morningside Drive
Americus, GA 31709
Phone (229) 942-9534

Other identifiers 1

IdentifierTypeStateIssuer
00075963GMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120911000549 GA Part B Supplier - Clinic/Group Practice 1850549148 Receives reassigned benefits from 1 practitioner
Practice locations: Americus, GA

National Provider Directory

National Provider Directory

Locations

136 S Lee St
Ste A
Americus, GA 31709
Phone (229) 380-0266

138 S Lee St
Ste A
Americus, GA 31709
Phone (229) 380-0255

910 N 5th St
Cordele, GA 31015
Phone (229) 271-4652

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1831445634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 MORNINGSIDE DRIVE",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "31709",
            "telephone_number": "229-942-9534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S LEE ST STE A",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093698",
            "telephone_number": "229-380-0266",
            "fax_number": "229-380-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AJAY M KOTHARI MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-30",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "KOTHARI",
        "authorized_official_first_name": "AJAY",
        "authorized_official_middle_name": "MAHESHCHANDRA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "229-942-9534",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "26984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00075963G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Americus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.