Anitha Koduru (NPI# 1689803785, PAC ID# 1153558820) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1689803785 |
| PAC ID by PECOS | 1153558820 |
| Professional Enrollment ID | I20180831000762 |
| Full Name | Anitha Koduru |
| Organization Legal Name | UNIVERSITY MEDICAL GROUP LLC |
| Address |
447 N Belair Rd Suite 104 Evans GA 30809-3091 |
| Phone Number | 7068542222 |
| Gender | F |
| Graduation Year | 2005 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | GERIATRIC MEDICINE |
| Group Practice PAC ID | 2567640915 |
| Number of Group Practice Members | 29 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110028 | UNIVERSITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 447 N Belair Rd, Suite 104, Evans, GA 30809-3091 | 7068542222 | UNIVERSITY MEDICAL GROUP LLC |
| 925 Branch Ct, Suite 201, Grovetown, GA 30813-3325 | 7063963570 | UNIVERSITY MEDICAL GROUP LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_110_overall | Preventive Care and Screening: Influenza Immunization | 99% | |
| MIPS_EC_110_overall | Preventive Care and Screening: Influenza Immunization | 99% | |
| MIPS_EC_154_overall | Falls: Risk Assessment | 100% | |
| MIPS_EC_154_overall | Falls: Risk Assessment | 100% | |
| MIPS_EC_155_overall | Falls: Plan of Care | 99% | |
| MIPS_EC_155_overall | Falls: Plan of Care | 99% | |
| MIPS_EC_181_overall | Elder Maltreatment Screen and Follow-Up Plan | 100% | |
| MIPS_EC_181_overall | Elder Maltreatment Screen and Follow-Up Plan | 100% |
| Organization Legal Name | UNIVERSITY MEDICAL GROUP LLC |
| Physicians | 36 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shannon Leigh Whitwell | Nurse Practitioner | University Medical Group LLC | 1100 W Lake Commons Dr, Martinez, GA 30907-7932 |
| Lisa Wannamaker | Internal Medicine | University Medical Group LLC | 4446 Washington Eroad, Suite 7, Evans, GA 30809 |
| Lindsey Meagher | Nurse Practitioner | University Medical Group LLC | 3121 Peach Orchard Rd, Suite 103, Augusta, GA 30906-3531 |
| Eman L Kaldas | Internal Medicine | University Medical Group LLC | 3486 Peach Orchard Rd, Suite 100, Augusta, GA 30906-5215 |
| Jennifer Herbert | Family Medicine | University Medical Group LLC | 3851 Evans Locks Rd, Se 113, Martinez, GA 30907-4914 |
| Alison Powell | Nurse Practitioner | University Medical Group LLC | 309 W Ave, Umg Family Practice, North Augusta, SC 29841-3800 |
| Vanessa Bradish | Nurse Practitioner | University Medical Group LLC | 465 N Belair Rd, 2b, Evans, GA 30809-3190 |
| Daniel H Boone | Internal Medicine | University Medical Group LLC | 465 N Belair Rd, 2b, Evans, GA 30809-3190 |
| Christopher S Mcelroy | Internal Medicine | University Medical Group LLC | 465 N Belair Rd, 2b, Evans, GA 30809-3190 |
| Hannah Timmerman Cofer | Nurse Practitioner | University Medical Group LLC | 3486 Peach Orchard Rd, Suite 100, Augusta, GA 30906-5215 |
| Street Address |
447 N BELAIR RD SUITE 104 |
| City | EVANS |
| State | GA |
| Zip | 30809-3091 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kevin Trapnell | Emergency Medicine | Umg Prompt Care LLC | 447 N Belair Rd, Suite 101, Evans, GA 30809-3091 |
| Kelly Blount | Physician Assistant | Umg Prompt Care LLC | 447 N Belair Rd, Suite 101, Evans, GA 30809-3091 |
| Falguni Patel | Physician Assistant | Umg Prompt Care LLC | 447 N Belair Rd, Suite 101, Evans, GA 30809-3091 |
| Julie P Hicks | Emergency Medicine | Umg Prompt Care LLC | 447 N Belair Rd, Suite 101, Evans, GA 30809-3091 |
| Erinn Beasley | Nurse Practitioner | Umg Prompt Care LLC | 447 N Belair Rd, Suite 101, Evans, GA 30809-3091 |
| Susan M Towner | Nurse Practitioner | Umg Prompt Care LLC | 447 N Belair Rd, Suite 101, Evans, GA 30809-3091 |
| Angela Barco | Nurse Practitioner | Umg Prompt Care LLC | 447 N Belair Rd, Suite 101, Evans, GA 30809-3091 |
| Tammi B Pavey | Physician Assistant | Umg Prompt Care LLC | 447 N Belair Rd, Suite 101, Evans, GA 30809-3091 |
| Chasity G Rabun | Nurse Practitioner | Umg Prompt Care LLC | 447 N Belair Rd, Suite 101, Evans, GA 30809-3091 |
| Billie C Blackburn | Nurse Practitioner | Umg Prompt Care LLC | 447 N Belair Rd, Suite 101, Evans, GA 30809-3091 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lisa Wannamaker | Internal Medicine | University Medical Group LLC | 4446 Washington Eroad, Suite 7, Evans, GA 30809 |
| Gena Bonitatibus | Allergy/immunology | 4350 Towne Ctr Dr, Suite 1500, Evans, GA 30809 | |
| Eric J Larson | Chiropractic | 676 Mullins Colony Dr, Evans, GA 30809-0579 | |
| Jonathan William Rutledge | Otolaryngology | Augusta Ent PC | 340 N Belair Rd, Evans, GA 30809-3000 |
| Edward Austin Porubsky | Otolaryngology | Augusta Ent PC | 340 N Belair Rd, Evans, GA 30809-3000 |
| Ralph G Owen | Otolaryngology | Augusta Ent PC | 340 N Belair Rd, Evans, GA 30809-3000 |
| William A Wells | Otolaryngology | Augusta Ent PC | 340 N Belair Rd, Evans, GA 30809-3000 |
| Vanitcha R Pintavorn | Allergy/immunology | Augusta Ent PC | 340 N Belair Rd, Evans, GA 30809-3000 |
| Bari F Levens | Qualified Audiologist | Augusta Ent PC | 340 N Belair Rd, Evans, GA 30809-3000 |
| Robert T Deal | Otolaryngology | Augusta Ent PC | 340 N Belair Rd, Evans, GA 30809-3000 |
| Find all physicians in zip 30809 | |||
| City | EVANS |
| Zip Code | 30809 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | EVANS + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Anitha Koduru.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.