Chadalavada N Kishore, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

027846 Issued in GA

Practice address

425 Third Ave
Ste 340
Albany, GA 31701

Phone

(229) 312-9150

Fax

(229) 435-5590

NPI assigned

Aug 25, 2005

Last updated

Nov 1, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Internal Medicine

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoebe Physician Group IncGroup PAC ID 8426112350, 420 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phoebe Hospice Hospice, Albany, GA, CCN 111527

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Phoebe Putney Memorial Hospital, Inc.

  dba Phoebe Hospice

  • Community Based Hospice Care Agency
  • Albany, GA
  • NPI 1851356349

  Corporate Officer

  CMS ownership

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.

• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment Care Compare group NPD
• Phoebe Putney Memorial Hospital Inc

  dba Phoebe Putney Memorial Hosptial

  • General Acute Care Hospital
  • Albany, GA
  • NPI 1992789721
  Medicare reassignment NPD
• Phoebe Orthopedic Specialists

  • Clinic/Center
  • Albany, GA
  • NPI 1871891127
  NPD
• Phoebe Putney Memorial Hospital Inc

  dba Phoebe Specialty Pharmacy

  • Community/Retail Pharmacy
  • Albany, GA
  • NPI 1891315420
  NPD
• Phoebe Putney Memorial Hospital, Inc.

  dba Phoebe Family Medical Center - Pelham

  • Rural Health Clinic/Center
  • Pelham, GA
  • NPI 1821239765
  NPD
• Phoebe Putney Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Camilla, GA
  • NPI 1821293788
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Phoebe Putney Memorial Hospital, Inc.

  dba Phoebe Hospice

  • Community Based Hospice Care Agency
  • Albany, GA
  • NPI 1851356349
  Care Compare affiliation

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288569600000",
    "number": "1891788741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84009",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319084009",
            "telephone_number": "229-312-5800",
            "fax_number": "229-312-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 THIRD AVE",
            "address_2": "STE 340",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "31701",
            "telephone_number": "229-312-9150",
            "fax_number": "229-435-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISHORE",
        "first_name": "CHADALAVADA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2010-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "GA",
            "license": "27846",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "027846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00312881A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000312881C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kingdom Empowerment (Inteq Alliance)
• Marsha E Kinnett, ANP
• Davis L Kinney, DC
• Joshua A Kinsey, MD
• Shawona Monee Walker Kirk, PHARM.D.
• Kay Cooper Kitchen, MD
• Steven E Kitchen X, MD
• Kirby Kitchens, CRNA
• Gilbert South Klemann, M.D.
• Ira G Knepp, M.D.

• Geriatric Medicine (Internal Medicine) Physician in Albany, GA
• Providers in Albany, GA by specialty
• Geriatric Medicine (Internal Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.