Active NPI
Sage Health Senior Care PC
- Geriatric Medicine (Family Medicine) Physician
- Kennesaw, GA
National Provider Identifier
1902578586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | Primary | ||
| Geriatric Medicine (Internal Medicine) Physician | 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 DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Geriatric Medicine (Internal Medicine) Physician
- San Francisco, CA
- NPI 1790963502
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.