Individual provider Active NPI

Sharmin Banu Anam, M.D.

  • Family Medicine Physician
  • Suwanee, GA
National Provider Identifier
1922307610
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
71957 Issued in GA
Practice address
4235 Johns Creek Pkwy
Suite a
Suwanee, GA 30024-6038
Phone
(770) 442-1911
Fax
(678) 802-5765
NPI assigned
Mar 21, 2011
Last updated
Dec 13, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 71957 GA Primary

Addresses

Primary practice location

4235 Johns Creek Pkwy
Suite a
Suwanee, GA 30024-6038

Mailing address

3400 Old Milton Pkwy
Ste C270
Alpharetta, GA 30005-4414
Phone (770) 442-1911

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
I20140923001564 GA Practitioner - Family Practice 9931328036 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
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)

4235 Johns Creek Pkwy
Suite a
Suwanee, GA 30024-6038
Phone (770) 442-1911

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Group, P.C. Family Medicine CurrentSince Mar 4, 2017 Accepting new patients
Peachtree Immediate Care FP, LLC Family Medicine CurrentSince May 19, 2018 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Aug 18, 2023 Accepting new patients

Locations

3400 Old Milton Pkwy
Ste C270
Alpharetta, GA 30005
Phone 7704421911233

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

4400 Peachtree Rd NE
Brookhaven, GA 30319
Phone (404) 814-9199

1829 Lawrenceville Hwy
Decatur, GA 30033
Phone (404) 292-8335

590 Lanier Ave W
Fayetteville, GA 30214

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

1700 Medical Way
Snellville, GA 30078
Phone (770) 978-4229

4235 Johns Creek Pkwy
Ste A
Suwanee, GA 30024
Phone (678) 402-9550

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA
  • Direct secure messaging: sharminbanuanam@napc.allscriptsdirect.net

Organizations & group practices 4

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.

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": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1922307610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 OLD MILTON PKWY",
            "address_2": "STE C270",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054414",
            "telephone_number": "770-442-1911",
            "fax_number": "770-663-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 JOHNS CREEK PKWY",
            "address_2": "SUITE A",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246038",
            "telephone_number": "770-442-1911",
            "fax_number": "678-802-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANU ANAM",
        "first_name": "SHARMIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-21",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "71957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.