Individual provider Active NPI

Rani S. Reddy, M.D.

  • Internal Medicine Physician
  • Statesboro, GA
National Provider Identifier
1841218013
Registry record updated Oct 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
034450 Issued in GA
Practice address
106 Briarwood Rd
Statesboro, GA 30458-2459
Phone
(912) 871-5000
Fax
(912) 681-1444
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2009

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 034450 GA Primary

Addresses

Primary practice location

106 Briarwood Rd
Statesboro, GA 30458-2459

Mailing address

106 Briarwood Rd
Statesboro, GA 30458-2459
Phone (912) 871-5000

Other identifiers 1

IdentifierTypeStateIssuer
00468201EMedicaidGA

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
I20101018000985 GA Practitioner - Internal Medicine 9234177262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeast Medical Group, P.C.Group PAC ID 3577559673, 139 clinicians

Practice addresses (Care Compare)

1035 Southcrest Dr
Suite 200
Stockbridge, GA 30281-6116
Phone (770) 442-1911

106 Briarwood Rd
Statesboro, GA 30458-2459
Phone (770) 442-1911

1255 Friendship Rd
Suite 130
Braselton, GA 30517-5617
Phone (770) 442-1911

4300 N Point Pkwy
Suite 300
Alpharetta, GA 30022-4102

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Group, P.C. CurrentSince Jan 24, 2022 Accepting new patients

Locations

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

380 Sconyers St
Metter, GA 30439
Phone (912) 685-1215

380 Cedar St
Metter, GA 30439
Phone (912) 685-1779

106 Briarwood Rd
Statesboro, GA 30458
Phone (912) 871-5000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255910400000",
    "number": "1841218013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 BRIARWOOD RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304582459",
            "telephone_number": "912-871-5000",
            "fax_number": "912-681-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 BRIARWOOD RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304582459",
            "telephone_number": "912-871-5000",
            "fax_number": "912-681-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "RANI",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2009-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "034450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00468201E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.