DR. SUSHMA KAKKERALA (NPI# 1326395948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326395948 |
| Entity Type | Individual |
| Full Name | DR. SUSHMA KAKKERALA |
| Credential | M.D. |
| Practice Address |
204 N Westover Blvd Albany GA 31707-2983 |
| Mailing Address |
4201 St. Antoine Uhc 5d - Mailbox 226 Detroit MI 48201-2153 |
| Practice Telephone | 2298886559 |
| Practice Fax Number | 2294364107 |
| Mailing Telephone | 3139665051 |
| Mailing Fax Number | 3139660665 |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2020-08-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 4301501155 | MI | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 074206 | GA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
204 N WESTOVER BLVD |
| City | ALBANY |
| State | GA |
| Zip Code | 31707-2983 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356337786 | Charles Brent Tyler | Internal Medicine | 204 N Westover Blvd, Albany, GA 31707-2983 | 2005-09-21 |
| 1528689577 | Tiara S Marshall | Student in an Organized Health Care Education/Training Program | 204 N Westover Blvd, Albany, GA 31707-2983 | 2020-04-30 |
| 1003361064 | Rhonda Jeannean Haynes | Nurse Practitioner | 204 N Westover Blvd, Albany, GA 31707-2983 | 2016-08-19 |
| 1255885109 | Kathleen C. Harvey | Nurse Practitioner | 204 N Westover Blvd, Albany, GA 31707-2983 | 2016-08-09 |
| 1679027478 | Lori C Hobbs | Nurse Practitioner | 204 N Westover Blvd, Albany, GA 31707-2983 | 2016-08-09 |
| 1730536020 | Jasmine Edwards | Dentist | 204 N Westover Blvd, Albany, GA 31707-2983 | 2016-05-17 |
| 1477908580 | Melissa Miller Stevenson | Nurse Practitioner | 204 N Westover Blvd, Albany, GA 31707-2983 | 2016-04-26 |
| 1881057792 | Sarah Elizabeth Waling | Pediatrics | 204 N Westover Blvd, Albany, GA 31707-2983 | 2016-03-30 |
| 1861817181 | Joana Dorwuona-tettey | Pediatrics | 204 N Westover Blvd, Albany, GA 31707-2983 | 2014-02-24 |
| 1174558746 | Albany Area Primary Health Care, Inc. | Clinic/Center | 204 N Westover Blvd, Albany, GA 31707-2983 | 2006-07-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396394011 | Barbara Cannon | Technician | 2025 Gail Avenue, Albany, GA 31707 | 2019-09-05 |
| 1669941035 | Wallace Coleman | Counselor | 2403 Osler Court, Suite B, Albany, GA 31707 | 2018-11-15 |
| 1992293955 | Tiffany Timmerman | Massage Therapist | Albany Therapeutic Massage Clinic, 1534 Dawson, Rd, Albany, GA 31707 | 2018-04-25 |
| 1225550957 | Christopher George Solomon | Nurse Practitioner | 2336 Dawson Rd., Urgent Care Center At Phoebe Northwest, Albany, GA 31707 | 2017-07-14 |
| 1689107229 | Teemercare @ Home LLC | Home Health | 1129 Dawson Rd Ste A, Albany, GA 31707 | 2017-04-11 |
| 1205373917 | Nicarro Henderson | Specialist | 2005 E Dawson Rd, Albany, GA 31707 | 2017-01-20 |
| 1235567918 | Restoration of The Minds LLC | Community/Behavioral Health | 1408 Edgerly Avenue, Albany, GA 31707 | 2013-10-16 |
| 1588091334 | Marsha Danell Glover | Pediatrics | 517 N. Westover Blvd., Albany, GA 31707 | 2013-10-10 |
| 1003253139 | Bailey Healthcare Inc | Community/Behavioral Health | 2416 Suite B Westgate Dr, Albany, GA 31707 | 2013-05-30 |
| 1346685666 | Albany Urology Surgery Center LLC | Clinic/Center | 2400 Osler Court, Albany, GA 31707 | 2013-04-30 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053719302 | Leland Lamar Wince | Pediatrics | 8040 East Clifton Rd, Albany, IN 47320 | 2014-12-18 |
| 1609292697 | Kathleen Keating | Pediatrics | 1 Park Pl Ste 200, Albany, NY 12205-2676 | 2014-03-14 |
| 1588091334 | Marsha Danell Glover | Pediatrics | 517 N. Westover Blvd., Albany, GA 31707 | 2013-10-10 |
| 1275816548 | Community Care Physicians, PC | Pediatrics | 6 Executive Park Drive, Albany, NY 12203-3791 | 2011-09-23 |
| 1265750061 | Douglas Beaty Fair | Pediatrics | 540 Myrtle Ave, Albany, NY 12208-3303 | 2010-05-04 |
| 1962732735 | Debra Blog | Pediatrics | Bureau of Immunization New York State Dept Ofhealth, Empire State Plaza, Corning Tower, Room 649, Albany, NY 12237-0001 | 2009-12-30 |
| 1184825101 | Shirley K Catron M D Psc | Pediatrics | 701 Burkesville Rd, Albany, KY 42602-1654 | 2007-05-29 |
| 1902984784 | Donald N. Mangravite | Pediatrics | 1114 Curtis St, Albany, CA 94706-2421 | 2006-11-01 |
| 1366553901 | Tania Smith | Pediatrics | 600 Pointe North Blvd, Albany, GA 31721-1513 | 2006-08-31 |
| 1861409435 | Cajsa Jane Schumacher | Pediatrics | 103 Great Oaks Blvd, Albany, NY 12203 | 2006-08-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.