Individual provider Active NPI

Angampally G Rajeev, MD

  • Interventional Cardiology Physician
  • Lagrange, GA
National Provider Identifier
1891738118
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
57240 Issued in GA
Practice address
1551 Doctors Drive
BLDG 200
Lagrange, GA 30240-4139
Phone
(706) 884-2641
Fax
(706) 884-2353
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 057240 GA
Interventional Cardiology Physician 207RI0011X 04-32029 KS
Interventional Cardiology Physician 207RI0011X 057240 GA
Interventional Cardiology Physician 207RI0011X 57240 GA Primary

Addresses

Primary practice location

1551 Doctors Drive
BLDG 200
Lagrange, GA 30240-4139

Mailing address

1551 Doctors Drive
Lagrange, GA 30240-4139
Phone (706) 884-2641

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
I20060616000038 GA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3274545041 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

505 Jenkins St
Lagrange, GA 30240-4225
Phone (706) 407-0161

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting11
Pacemaker insertion or repair1-10
Varicose vein removal19
Leg revascularization (restoring blood flow)54

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-32029KSMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System in Waycross, Inc CurrentSince Feb 25, 2014 Accepting new patients
Mayo Clinic Health System in Waycross, Inc. CurrentSince Feb 25, 2014 Accepting new patients
Center for Podiatry Care Interventional Cardiology CurrentSince Aug 1, 2020 Accepting new patients
Upson Surgical Associates, LLC CurrentSince Dec 16, 2020 Accepting new patients
Integrated Regional Laboratories Pathology Services, LLC Current Accepting new patients
Heart & Vascular Care of Georgia PC Cardiovascular Disease CurrentSince Jun 1, 2013 Accepting new patients
Tanner Medical Group Inc Cardiovascular Disease CurrentSince Jul 1, 2015 Accepting new patients
Lagrange Troup County Hospital Authority Past Accepting new patients

Locations

157 Clinic Ave
Ste 302A
Carrollton, GA 30117
Phone (770) 812-5886

505 Jenkins St
Lagrange, GA 30240
Phone (706) 407-0161

1514 Vernon Rd
Lagrange, GA 30240
Phone (706) 812-2369

462 Furys Ferry Rd
Martinez, GA 30907
Phone (706) 868-0319

23 Old Atlanta Hwy
Ste 110
Newnan, GA 30263
Phone (678) 621-2345

612 W Gordon St
Ste B
Thomaston, GA 30286
Phone (706) 647-9433

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

601 Dallas Hwy
Villa Rica, GA 30180
Phone (770) 456-3000

1900 Tebeau St
Waycross, GA 31501
Phone (912) 283-3030

1921 Alice St
Ste 4B
Waycross, GA 31501
Phone (912) 285-5690

Interoperability endpoints

  • Direct secure messaging: angampally.rajeev@westgahealth.gadirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/HHFCCA

Organizations & group practices 9

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 5

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1891738118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 DOCTORS DRIVE",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404139",
            "telephone_number": "706-884-2641",
            "fax_number": "706-884-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 DOCTORS DRIVE",
            "address_2": "BLDG 200",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404139",
            "telephone_number": "706-884-2641",
            "fax_number": "706-884-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJEEV",
        "first_name": "ANGAMPALLY",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "057240",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KS",
            "license": "04-32029",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "057240",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "57240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.