Individual provider Active NPI

Syamala D Erramilli, MD

  • Internal Medicine Physician
  • Johns Creek, GA
National Provider Identifier
1891706974
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
047896 Issued in GA
Practice address
9105 Etching Overlook
Johns Creek, GA 30097-6412
Phone
(678) 971-2020
Fax
(678) 666-1300
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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 047896 GA Primary

Addresses

Primary practice location

9105 Etching Overlook
Johns Creek, GA 30097-6412

Mailing address

2926 Mountain Industrial Blvd.
Tucker, GA 30084
Phone (678) 971-2020

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
I20051031000194 GA Practitioner - Internal Medicine 4486671401 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Medical Group, P.C.Group PAC ID 3577559673, 139 clinicians

Practice addresses (Care Compare)

4865 Lavista Rd
Suite a
Tucker, GA 30084-4436
Phone (770) 442-1911

9105 Etching Overlook
Johns Creek, GA 30097-6412
Phone (678) 860-5415

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 Nov 28, 2022 Accepting new patients
Wellbe Senior Medical Group of Georgia, P. C. Internal Medicine CurrentSince Sep 16, 2023 Accepting new patients
Gwinnett Physician Group, LLC Internal Medicine PastSince Nov 28, 2022 Accepting new patients

Locations

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

4300 Northpoint Pkwy
Ste 300
Johns Creek, GA 30022
Phone (770) 518-4406

310 Philip Blvd
Lawrenceville, GA 30046
Phone (678) 442-0991

771 Old Norcross Rd
Ste 225
Lawrenceville, GA 30046
Phone (678) 802-4045

5 Concourse Pkwy
Ste 3100
Sandy Springs, GA 30328
Phone (855) 492-7642

2926 Mountain Industrial Blvd
#B
Tucker, GA 30084
Phone (770) 414-5588

2926 Mountain Industrial Blvd
Tucker, GA 30084
Phone (678) 860-5415

4865 Lavista Rd
Ste A
Tucker, GA 30084
Phone (770) 270-0290

Interoperability endpoints

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

Organizations & group practices 3

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1891706974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2926 MOUNTAIN INDUSTRIAL BLVD.",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "30084",
            "telephone_number": "678-971-2020",
            "fax_number": "678-666-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9105 ETCHING OVERLOOK",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300976412",
            "telephone_number": "678-971-2020",
            "fax_number": "678-666-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERRAMILLI",
        "first_name": "SYAMALA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "047896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

Verify at the official NPI Registry.