KANAK NAIDU (NPI# 1336224799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336224799 |
| Entity Type | Individual |
| Full Name | KANAK NAIDU |
| Credential | M.D. |
| Practice Address |
1 Freedom Way Augusta GA 30904-6258 |
| Mailing Address |
200 Corporate Blvd Suite 201 Lafayette LA 70508-3870 |
| Practice Telephone | 3183490256 |
| Mailing Telephone | 8008939698 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2019-03-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | MD.200714 | LA | Other Service Providers |
| Y | 207P00000X | Emergency Medicine | M-1725 | GU | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 200714 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | STATE LICENSE | MD.200714 | 01 |
| Street Address |
1 FREEDOM WAY |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904-6258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912900713 | Robert Leon Longe | Pharmacist | 1 Freedom Way, Augusta, GA 30904-6258 | 2005-05-24 |
| 1609476951 | Melissa Ann Cotton | Dentist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-27 |
| 1487253217 | Kelsey Shull | Recreation Therapist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-22 |
| 1437758844 | Angela Marie Brown | Social Worker | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-19 |
| 1538767819 | Stephen William Montgomery | Music Therapist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-09 |
| 1134726631 | Rebecca Leigh Halioua | Recreation Therapist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-07 |
| 1104435718 | Vincent Michael Fitch | Psychologist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-07-29 |
| 1558988162 | Amanda Draheim | Psychologist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-06-30 |
| 1174140784 | Tiffany Ariel Graves | Student in an Organized Health Care Education/Training Program | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-06-30 |
| 1982221776 | Janice J Anglin | Dietitian, Registered | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1124552690 | Jenny Liles | Student in an Organized Health Care Education/Training Program | 1004 Chafee Ave, Augusta, GA 30904 | 2017-04-11 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| Find all providers in zip 30904 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215310768 | John Bates Mccutcheon | Emergency Medicine | 3138 Westminster Dr, Augusta, GA 30909-3242 | 2015-07-01 |
| 1891114492 | Darrel Douglas | Emergency Medicine | 1120 15th St # Af-1020, Augusta, GA 30912-0004 | 2014-04-10 |
| 1740624774 | Desiree Brooks | Emergency Medicine | 1507 Troupe St, Apt #5, Augusta, GA 30904-5099 | 2013-04-21 |
| 1316258932 | Charles Robert Sheldon | Emergency Medicine | 2704 Smith Creek Rd, Augusta, GA 30909-2322 | 2010-06-29 |
| 1679899215 | Beau Philip Gedrick | Emergency Medicine | 1102 15th St, Augusta, GA 30912-0004 | 2010-04-07 |
| 1245492958 | Abhijit Singh | Emergency Medicine | 1120 15th Street Augusta University Medical Center, Augusta, GA 30912-2504 | 2008-06-25 |
| 1487870168 | Suzanne Joy Atteberry | Emergency Medicine | 1120 15th St Rm Af-2056, Augusta, GA 30912-0004 | 2007-04-18 |
| 1427086909 | Tricia-may Villanueva Harris | Emergency Medicine | 3651 Wheeler Road, Augusta, GA 30909 | 2006-06-30 |
| 1093758724 | George Clark Pursley | Emergency Medicine | 1219 West Wheeler Pkwy, Suite A, Augusta, GA 30909-1867 | 2006-06-13 |
| 1760434757 | Wakili Salihu Yarima | Emergency Medicine | 1120 15th Street Af 2036, Emergency Medicine Department, Medical College of Georgia, Augusta, GA 30912 | 2006-05-17 |
| Find all providers in AUGUSTA | ||||
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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.