Individual provider Active NPI

Sudha Dharmareddi Reddy, M.D.

  • Emergency Medicine Physician
  • Kennesaw, GA
National Provider Identifier
1932208055
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
053871 Issued in GA
Practice address
750 Town Park Lane
Kaiser Permanente Town Park Medical Center
Kennesaw, GA 30144
Phone
(770) 514-5464
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 053871 GA Primary

Addresses

Primary practice location

750 Town Park Lane
Kaiser Permanente Town Park Medical Center
Kennesaw, GA 30144

Mailing address

3495 Piedmont Road, NE
Nine Piedmont Center
Atlanta, GA 30305
Phone (404) 364-7070

Other identifiers 1

IdentifierTypeStateIssuer
310618202BMedicaidGA

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
I20040723000366 GA Practitioner - Emergency Medicine 7214917889 Reassigns benefits to 4 organizations
Practice locations: Newnan, GA

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Morehouse School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

2450 Old Milton Pkwy
Alpharetta, GA 30009-2520

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

780 Church St NE
Marietta, GA 30060-7269

8901 Stonebridgde Blvd
Suite 100
Douglasville, GA 30134-2253
Phone (943) 202-7100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.23
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
The Bortolazzo Group, LLC Emergency Medicine CurrentSince Oct 1, 2006 Accepting new patients
Wayne Emergency Group LLC Emergency Medicine CurrentSince Jul 2, 2022 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Nov 1, 2011 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Aug 1, 2022 Accepting new patients
Inphynet Primary Care Physicians Southeast PC Emergency Medicine Past Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

600 W Memorial Dr
Dallas, GA 30132
Phone (770) 443-7072

8954 Hospital Dr
Douglasville, GA 30134
Phone (678) 838-2584

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

101 Lake Oconee Pkwy
Eatonton, GA 31024
Phone (706) 485-0907

865 S 1st St
Jesup, GA 31545
Phone (912) 427-6811

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500

801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 6

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 2

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1932208055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT ROAD, NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30305",
            "telephone_number": "404-364-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 TOWN PARK LANE",
            "address_2": "KAISER PERMANENTE TOWN PARK MEDICAL CENTER",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "30144",
            "telephone_number": "770-514-5464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "SUDHA",
        "middle_name": "DHARMAREDDI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "053871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310618202B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.