Active NPI
Vandana Chakravarthy Centa, D.O
- Internal Medicine Physician
- Colbert, GA
National Provider Identifier
1881607000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 057054
- Practice address
- 11 Charlie Morris Rd
Colbert, GA 30628-2445 - Phone
- (706) 788-3234
- Fax
- (706) 788-2936
- NPI assigned
- Aug 15, 2006
- Last updated
- Apr 17, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 057054 | GA | Primary |
| Internal Medicine Physician | 207R00000X | 3099 | AZ |
Addresses
Primary practice location
11 Charlie Morris Rd
Colbert, GA 30628-2445
Mailing address
PO Box 459
Colbert, GA 30628-0459
Phone (706) 788-3234
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 136315049C | Medicaid | GA |
Other names 1
- Dr. Vandana Sreenathan Chakravarthy
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)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3099 | AZ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Drake D Duane MD PC | 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.
-
- Neurology Physician
- Scottsdale, AZ
- NPI 1740365048
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429228800000",
"number": "1881607000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 459",
"city": "COLBERT",
"state": "GA",
"postal_code": "306280459",
"telephone_number": "706-788-3234",
"fax_number": "706-788-2936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 CHARLIE MORRIS RD",
"city": "COLBERT",
"state": "GA",
"postal_code": "306282445",
"telephone_number": "706-788-3234",
"fax_number": "706-788-2936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CENTA",
"first_name": "VANDANA",
"middle_name": "CHAKRAVARTHY",
"name_prefix": "Dr.",
"credential": "D.O",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-15",
"last_updated": "2015-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "057054",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "3099",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "136315049C",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "VANDANA",
"last_name": "CHAKRAVARTHY",
"middle_name": "SREENATHAN",
"prefix": "DR.",
"credential": "D.O",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Colbert, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.