DR. SIVASANKER BAKTHAVACHALAM (NPI# 1730390204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730390204 |
| Entity Type | Individual |
| Full Name | DR. SIVASANKER BAKTHAVACHALAM |
| Other Name | DR. SIVI BAKTHAVACHALAM |
| Credential | M.D. |
| Practice Address |
5461 Meridian Marks Rd Ste 130 Atlanta GA 30342 |
| Mailing Address |
5461 Meridian Marks Rd Ste 130 Atlanta GA 30342-3009 |
| Practice Telephone | 4042552033 |
| Mailing Telephone | 4042552033 |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2018-05-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YP0228X |
Otolaryngology Specialization: Pediatric Otolaryngology |
62182 | GA | Allopathic & Osteopathic Physicians |
| N | 207YS0012X |
Otolaryngology Specialization: Sleep Medicine |
M6033 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 903058052 | 05 |
| Street Address |
5461 MERIDIAN MARKS RD STE 130 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316928823 | James Thomsen | Otolaryngology | 5461 Meridian Marks Rd Ste 130, Atlanta, GA 30342 | 2005-11-10 |
| 1457984130 | Meagan Huff Braswell | Nurse Practitioner | 5461 Meridian Marks Rd Ste 130, Atlanta, GA 30342-3009 | 2020-02-20 |
| 1447801170 | Callie Henley Adams | Audiologist | 5461 Meridian Marks Rd Ste 130, Atlanta, GA 30342-3009 | 2019-09-24 |
| 1750943163 | Megan Elizabeth Hinson | Audiologist | 5461 Meridian Marks Rd Ste 130, Atlanta, GA 30342-3009 | 2019-07-05 |
| 1538661277 | Mary Frances Doss | Nurse Practitioner | 5461 Meridian Marks Rd Ste 130, Atlanta, GA 30342-3009 | 2018-03-07 |
| 1629598396 | Amanda Leigh Platz | Audiologist | 5461 Meridian Marks Rd Ste 130, Atlanta, GA 30342 | 2017-06-23 |
| 1225328362 | Geoffrey Paul Aaron | Otolaryngology | 5461 Meridian Marks Rd Ste 130, Atlanta, GA 30342-3009 | 2011-04-11 |
| 1265619696 | Eric Edward Berg | Otolaryngology | 5461 Meridian Marks Rd Ste 130, Atlanta, GA 30342 | 2008-01-28 |
| 1689876872 | Matthew Kyle Whitley | Otolaryngology | 5461 Meridian Marks Rd Ste 130, Atlanta, GA 30342 | 2007-06-01 |
| 1437379351 | Paula J Harmon | Otolaryngology | 5461 Meridian Marks Rd Ste 130, Atlanta, GA 30342 | 2007-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820614 | Nia Charnice Griffin | Nurse Practitioner | 5670 Peachtree Dunwoodyroad, Suite 900, Atlanta, GA 30342 | 2020-10-26 |
| 1255945184 | Jennifer Lynne Cole | Behavior Technician | 5555 Glenridge Con Suite 200, Atlanta, GA 30342 | 2020-09-08 |
| 1093336232 | Van Tran | Respiratory Therapist, Registered | 1000 Johnson Ferry Rd Ne, Atlanta, Ga 30342, Atlanta, GA 30342 | 2020-04-28 |
| 1356978340 | Twyla Douglas Jackson I | Clinical Nutrition, 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342 | 2020-03-27 | |
| 1760013411 | Emily Hamm | Dietitian, Registered | 933 D Johnson Ferry Road, Suite 250, Atlanta, GA 30342 | 2020-01-31 |
| 1043855984 | Mackenzie Tucker Wayda | Registered Nurse | 1001 Johnson Ferry Rd. Ne, Atlanta, GA 30342 | 2019-11-14 |
| 1386288454 | Tiauna Lashun Cochman | Psychologist | 1307 Glenridge Dr, Sandy Springs, GA 30342 | 2019-11-01 |
| 1164074399 | Stephen J. White | Hearing Instrument Specialist | 5775 Peachtree Dunwoody Rd Suite 600 Fl. 6, Uhc Hearing, Atl., GA 30342 | 2019-07-09 |
| 1144788142 | Jaytyn LLC | Internal Medicine | 4600 Broswell Road, Atlanta, GA 30342 | 2019-03-08 |
| 1760954705 | Mishele Walker LLC | Counselor | 555 Glenridge Connector, Suite 200, Sandy Springs, GA 30342 | 2018-12-31 |
| Find all providers in zip 30342 | ||||
| Taxonomy Code | 207YP0228X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Pediatric Otolaryngology |
| A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134380017 | Pediatric Ear, Nose, & Throat of Atlanta, PC | Otolaryngology | 5461 Meridian Mark Road Suite 130, Atlanta, GA 30342 | 2008-06-23 |
| 1316928823 | James Thomsen | Otolaryngology | 5461 Meridian Marks Rd Ste 130, Atlanta, GA 30342 | 2005-11-10 |
| 1255759494 | Sean Spencer Evans | Otolaryngology | 1001 Johnson Ferry Rd Ne, Atlanta, GA 30322-1900 | 2014-04-04 |
| 1689019580 | Nandini Govil | Otolaryngology | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2013-05-06 |
| 1437493467 | Choa Multispecialty, LLC | Otolaryngology | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2012-11-15 |
| 1093011249 | Stephanie Ambrose | Otolaryngology | 550 Peachtree St Ne, Suite 1135, Atlanta, GA 30308-2212 | 2011-02-07 |
| 1588896351 | Jonathan Maclean | Otolaryngology | 1365a Clifton Rd Ne, Atlanta, GA 30322-1013 | 2009-08-12 |
| 1619139425 | Kara Kerscher Prickett | Otolaryngology | 2015 Uppergate Dr Ne, Atlanta, GA 30322-0001 | 2008-07-02 |
| 1689876872 | Matthew Kyle Whitley | Otolaryngology | 5461 Meridian Marks Rd Ste 130, Atlanta, GA 30342 | 2007-06-01 |
| 1497886428 | James Andrew Sipp | Otolaryngology | 5461 Meridian Marks Rd Ste 130, Atlanta, GA 30342 | 2007-03-09 |
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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.