Organization Active NPI

Sage Health Senior Care PC

  • Geriatric Medicine (Family Medicine) Physician
  • Kennesaw, GA
National Provider Identifier
1902578586
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
SAGE HEALTH SENIOR CARE PC
Practice address
1635 Old 41 Hwy NW Ste 112-216
Kennesaw, GA 30152-4480
Phone
(678) 626-1490
Fax
(404) 806-6668
NPI assigned
Oct 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Authorized official

Name
Dr. Arvind Chandilya Chakravarthy, MD
Title
Physician
Phone
(810) 814-0963

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207QG0300X Primary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X
In Home Supportive Care Agency 253Z00000X
Clinic/Center 261Q00000X
Rural Health Clinic/Center 261QR1300X

Addresses

Primary practice location

1635 Old 41 Hwy NW Ste 112-216
Kennesaw, GA 30152-4480

Mailing address

1635 Old 41 Hwy NW Ste 112-216
Kennesaw, GA 30152-4480
Phone (678) 626-1490

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645574400000",
    "number": "1902578586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 OLD 41 HWY NW STE 112-216",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524480",
            "telephone_number": "678-626-1490",
            "fax_number": "404-806-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 OLD 41 HWY NW STE 112-216",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524480",
            "telephone_number": "678-626-1490",
            "fax_number": "404-806-6668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE HEALTH SENIOR CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-01",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A",
        "authorized_official_last_name": "CHAKRAVARTHY",
        "authorized_official_first_name": "ARVIND",
        "authorized_official_middle_name": "CHANDILYA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "810-814-0963",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.