march provider directory addendum - kaiser...
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Medicare Provider Directory Addendum
60691108-G 04/2018
April 2018
Please review the changes that have occurred to our provider network as of April 2018. This document should be included with the complete 2018 Kaiser Permanente Senior Advantage Provider Directory. For the most current provider listings, please visit kp.org/directory.
If you have questions, please contact Kaiser Permanente Member Services at 1-800-232-4404, TTY 711, seven days a week, 8 a.m. to 8 p.m.
Georgia April
Additions Deletions Behavioral Health Internal Medicine Tia S Harrison, LCSW John M Read, III, MD Medical Center at Gwinnett Medical Center at Gwinnett 3650 Steve Reynolds Boulevard 3650 Steve Reynolds Boulevard Duluth, GA 30096 Duluth, GA 30096 404-365-0966 404-365-0966 Family Medicine Noreen A Mercando, DO Medical Center at Gwinnett 3650 Steve Reynolds Boulevard Duluth, GA 404-365-0966 Isioma C Okwumabua, MD Cumberland Medical Center 2525 Cumberland Parkway, SE Atlanta, GA 30339 404-365-0966 Geriatric Medicine Sharon P Henderson, NP Southwood Specialty Center 2470 Mount Zion Parkway Jonesboro, GA 30236 404-365-0966
Medicare Provider Directory Addendum
60691108-G 04/2018
April Additions Deletions
Obstetrics & Gynecology Jennifer Wendy Freeman Fortier, CNM Cumberland Medical Center 2525 Cumberland Parkway, SE Atlanta, GA 30339 404-365-0966 Oral & Maxillofacial Surgery Durwood M Johnson, Jr, DMD Atlanta Oral & Facial Surgery, LLC 1000 Johnson Ferry Road Building H Marietta, GA 30068 770-977-0364
Medicare Provider Directory Addendum
60691108-G 04/2018
March Additions Deletions
Behavioral Health Joan R Funk, LCSW, PhD Joan R Funk, LCSW, PhD 1640 Powers Ferry Road, SE Building 17, Suite 100 Marietta, GA 30067 770-426-9929 Candace M Morley, LCSW Southwood Medical Center 2400 Mount Zion Parkway Jonesboro, GA 30236 404-365-0966 Leslie M Sessley, LCSW Sessley Counseling Services, Inc 2784 North Decatur Road Suite 145 Decatur, GA 30033 404-840-1570 Derrick Williams, CSW Brookwood at Peachtree Medical Office 1745 Peachtree Street, NE, Suite U Atlanta, GA 30309 404-365-0966 Internal Medicine Raina M Phillips, MD Crescent Centre Medical Center 200 Crescent Centre Parkway Tucker, GA 30084 404-365-0966
Medicare Provider Directory Addendum
60691108-G 04/2018
March Additions Deletions
Obstetrics & Gynecology Rumbidzai M Cunningham, CNP Panola Medical Center 5440 Hillandale Drive Lithonia, GA 30058 404-365-0966 Pediatric Cardiology Stephanie B Wechsler, MD Sibley Heart Center Cardiology 5461 Meridian Mark Road Suite 530 Atlanta, GA 30342 404-256-2593 Physical Medicine & Rehabilitation Anne H Eliason, MD Southwood Medical Center 2400 Mount Zion Parkway Jonesboro, GA 30236 404-365-0966 Shamolie N Wyckoff, MD Medical Center at Gwinnett 3650 Steve Reynolds Boulevard Duluth, GA 30096 404-365-0966
Medicare Provider Directory Addendum
60691108-G 04/2018
February Additions Deletions
Family Medicine Internal Medicine Natasha Monique Oliver, NP Bridget Etter, MD TownPark Medical Center Southwood Medical Center 750 TownPark Lane, NW 2400 Mount Zion Parkway Kennesaw, GA 30144 Jonesboro, GA 30236 404-365-0966 404-365-0966 Hematology/Oncology Obstetrics & Gynecology Venkata Kiran Pokuri, MD Janet E O’Neal, CNM Medical Center at Gwinnett Southwood Medical Center 3650 Steve Reynolds Boulevard 2400 Mount Zion Parkway Duluth, GA 30096 Jonesboro, GA 30236 404-365-0966 404-365-0966 Neurosurgery Pediatric Infectious Disease Tariq Javed Jumi Yi, MD Tariq Javed, MD, PC CHOA Multispecialty, LLC 631 Campbell Hill Street, NW, Suite 100 1001 Johnson Ferry Road, NE Marietta, GA Atlanta, GA 30342 770-422-0444 404-785-2000 Obstetrics & Gynecology Jumi Yi, MD CHOA Multispecialty, LLC Sarah C Charlton, CNM 1405 Clifton Road, NE Southwood Medical Center Atlanta, GA 30322 2400 Mount Zion Parkway 404-785-2000 Jonesboro, GA 30236 404-365-0966
Medicare Provider Directory Addendum
60691108-G 04/2018
February Additions Deletions
Obstetrics & Gynecology Pediatric Infectious Disease Sarah C Charlton, CNM Jumi Yi, MD Panola Medical Center CHOA Multispecialty, LLC 5440 Hillandale Drive 975 Johnson Ferry Road, NE, Suite 340 Lithonia, GA 30058 Atlanta, GA 30342 404-365-0966 404-785-9077 Anita M Gandhi, MD Jumi Yi, MD TownPark Medical Center CHOA Multispecialty, LLC 750 TownPark Lane, NW 1000 Johnson Ferry Rd, NE Kennesaw, GA 30144 Atlanta, GA 30342 404-365-0966 404-785-0977 D’Nyce L Williams, MD Jumi Yi, MD Southwood Medical Center CHOA Multispecialty, LLC 2400 Mount Zion Parkway 5461 Meridian Mark Road, NE, Suite 520 Jonesboro, GA 30236 Atlanta, GA30342 404-365-0966 404-785-0977 Otolaryngology Roberto A Larrivey, MD Atlanta ENT, Sinus & Allergy Associates, LLC 5555 Peachtree Dunwoody Road, Suite 125 Atlanta, GA 30342 404-255-1971 Ramie A Tritt, MD Atlanta ENT, Sinus & Allergy Associates, LLC 5555 Peachtree Dunwoody Road, Suite 125 Atlanta, GA 30342 404-255-1971 Thomas J Walker, MD Atlanta ENT, Sinus & Allergy Associates, LLC 5555 Peachtree Dunwoody Road, Suite 125 Atlanta, GA 30342 404-365-0966 Pediatric Allergy & Immunology Brian P Vickery, MD CHOA Multispecialty, LLC 1605 Chantilly Drive, NE, Suite 305 Atlanta, GA 30324 404-785-2000
Medicare Provider Directory Addendum
60691108-G 04/2018
February Additions Deletions
Pediatric Allergy & Immunology Brian P Vickery, MD CHOA Multispecialty, LLC 1001 Johnson Ferry Road, NE Atlanta, GA 30342 404-785-2000 Brian P Vickery, MD CHOA Multispecialty, LLC 1405 Clifton Road, NE Atlanta, GA 30322 404-785-2000 Preeti Jaggi, MD CHOA Multispecialty, LLC 2015 Uppergate Drive, NE Atlanta, GA 30322 404-785-2000 Preeti Jaggi, MD CHOA Multispecialty, LLC 1000 Johnson Ferry Road, NE Atlanta, GA 30342 404-785-0977 Preeti Jaggi, MD CHOA Multispecialty, LLC 1001 Johnson Ferry Road, NE Atlanta, GA 30342 404-785-2000 Preeti Jaggi, MD CHOA Multispecialty, LLC 1405 Clifton Road, NE Atlanta, GA 30322 404-785-2000 Preeti Jaggi, MD CHOA Multispecialty, LLC 5461 Meridian Mark Road, NE, Suite 520 Atlanta, GA 30342 404-785-0977
Medicare Provider Directory Addendum
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February Additions Deletions
Pediatric Allergy & Immunology Preeti Jaggi, MD CHOA Multispecialty, LLC 550 Peachtree Street, NE Atlanta, GA 30308 404-785-2000 Pediatrics Michele Whiten Barton, CNP Alpharetta Medical Center 3550 Preston Ridge Road Alpharetta, GA 30005 404-365-0966 Vascular Surgery Veer Chahwala, MD Piedmont Cardiology of Atlanta, LLC 95 Collier Road, NW, Suite 5015 Atlanta, GA 30309 404-605-5699
Medicare Provider Directory Addendum
60691108-G 04/2018
January Additions Deletions
Behavioral Health Family Medicine April Marie Hicks, CSW Reneka L Dobbs-Jackson, MD Brookwood at Peachtree Medical Office Douglasville Medical Office 1745 Peachtree Street, NE, Suite U 6875 Douglas Boulevard, Suite A Atlanta, GA 30309 Douglasville, GA 30135 404-365-0966 404-365-0966 Shantreas N O’neil, LCSW Pediatrics Brookwood at Peachtree Medical Office 1745 Peachtree Street, NE, Suite U Loreen C Doyle-Littles, MD Atlanta, GA 30309 Cascade Medical Center 404-365-0966 1175 Cascade Parkway, SW Atlanta, GA 30311 Miesha Nanette Rhodes 404-365-0966 Stonecrest Medical Center 8011 Mall Parkway Lithonia, GA 30038 404-365-0966 Cardiology Sarah Forman Conkell, NP Glenlake Medical Center 20 Glenlake Parkway, NE Atlanta, GA 30328 404-365-0966 Robi Goswami, MD Medical Center at Gwinnett 3650 Steve Reynolds Boulevard Duluth, GA 30096 404-365-0966
Medicare Provider Directory Addendum
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January Additions Deletions
Family Medicine Tishana L Gary, CNP Cumberland Medical Center 2525 Cumberland Parkway, SE Atlanta, GA 30339 404-365-0966 Tishana L Gary, CNP West Cobb Medical Center 3640 Tramore Pointe Parkway Austell, GA 30106 404-365-0966 Joan M Gopin, MD Cumberland Medical Center 2525 Cumberland Parkway, SE Atlanta, GA 30039 404-365-0966 Theresa P Hudson, MD Douglasville Medical Office 6875 Douglas Boulevard, Suite A Douglasville, GA 30135 404-365-0966 Gloria E Okoye, NP West Cobb Medical Center 3640 Tramore Pointe Parkway Austell, GA 30106 404-365-0966 General Practice Jina Kim, MD Pleasant Hill Family Medicine 3610 Peachtree Industrial Boulevard, Suite 100 Duluth, GA 30096 678-417-0332 Internal Medicine Latonia Melissa Collier, NP-C Cascade Medical Center 1175 Cascade Parkway, SW Atlanta, GA 30311 404-365-0966
Medicare Provider Directory Addendum
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January Additions Deletions
Internal Medicine Latonia Melissa Collier, NP-C Douglasville Medical Office 6875 Douglas Boulevard, Suite A Douglasville, GA 30135 404-365-0966 Evelyn B Pryor, MD Sandy Springs Medical Office 1100 Lake Hearn Drive, NE Atlanta, GA 30342 404-365-0966 Obstetrics & Gynecology Jenna K Dannenbaum, CNP Medical Center at Gwinnett 3650 Steve Reynolds Boulevard Duluth, GA 30096 404-365-0966 Natasha Nicol Houston, PA Cascade Medical Center 1175 Cascade Parkway, SW Atlanta, GA 30311 404-365-0966 Charmaine T Pierce, CNM Medical Center at Gwinnett 3650 Steve Reynolds Boulevard Duluth, GA 30096 404-365-0966 Pediatric Endocrinology Eric E Berg, MD Pediatric Ear, Nose & Throat of Atlanta, PC 5461 Meridian Mark Rd, NE, Suite 130 Atlanta, GA 30342 404-255-2033
Medicare Provider Directory Addendum
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January Additions Deletions
Pediatrics Leah Beth Busse, MD Alpharetta Medical Center 3550 Preston Ridge Road Alpharetta, GA 30005 404-365-0966 Adrene M Sellers-Scott, MD Southwood Medical Center 2400 Mount Zion Parkway Jonesboro, GA 30236 404-365-0966
Medicare Provider Directory Addendum
60691108-G 04/2018
December Additions Deletions
Audiology Family Medicine Chesey S Cherian, AUD G Leonard Perryman, III, MD Medical Center at Gwinnett Cascade Medical Center 3650 Steve Reynolds Boulevard 1175 Cascade Parkway, SW Duluth, GA 30096 Atlanta, GA 30311 404-365-0966 404-365-0966 Behavioral Health General Surgery Michole J Allen, LCSW James B Bumgarner, MD Panola Medical Center Glenlake Medical Center 5440 Hillandale Drive 20 Glenlake Parkway, NE Lithonia, GA 30058 Atlanta, GA 30328 404-365-0966 404-365-0966 Family Medicine Internal Medicine Malita M Reese, NP Juanita F Cone, MD, MPH Crescent Centre Medical Center Crescent Centre Medical Center 200 Crescent Centre Parkway 200 Crescent Centre Parkway Tucker, GA 30084 Tucker, GA 30084 404-365-0966 404-365-0966 Orthopedic Surgery Bridget Etter, MD Southwood Medical Center Brigitte M Council, PA 2400 Mount Zion Parkway Medical Center at Gwinnett Jonesboro, GA 30236 3650 Steve Reynolds Boulevard 404-365-0966 Duluth, GA 30096 404-365-0966
Medicare Provider Directory Addendum
60691108-G 04/2018
December Additions Deletions
Pediatrics Internal Medicine Christine D Kofman, MD Marilavinia Jones, MD Southwood Medical Center Cascade Medical Center 2400 Mount Zion Parkway 1175 Cascade Parkway, SW Jonesboro, GA 30236 Atlanta, GA 30311 404-365-0966 404-365-0966 Psychiatry Maxwell Uhakheme, MD Douglasville Medical Office Sowmya K Kenia, MD 6875 Douglas Boulevard, Suite A Cumberland Medical Center Douglasville, GA 30135 2525 Cumberland Parkway, SE 404-365-0966 Atlanta, GA 30339 404-365-0966 Pediatrics Carol A Lehan, MD Holly Springs Medical Office 684 Sixes Road, Suite 275 Holly Springs, GA 30115 404-365-0966 Carol A Lehan, MD TownPark Medical Center 750 Townpark Lane, NW Kennesaw, GA 30144 404-365-0966
Medicare Provider Directory Addendum
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November Additions Deletions
Dermatology Cardiology Elizabeth M Seidler, MD Zena O Osakwe, NP Crescent Center Medical Center Medical Center at Gwinnett 200 Crescent Center Parkway 3650 Steve Reynolds Boulevard Tucker, GA 30084 Duluth, GA 30096 404-365-0966 404-365-0966 Gastroenterology Internal Medicine Isabell J Wells, PA Nikeva Johnson, MD Glenlake Medical Center Conyers Medical Office 20 Glenlake Parkway, NE 1478 Dogwood Drive, SE, Suite C Atlanta, GA 30328 Conyers, GA 30013 404-365-0966 404-365-0966 Geriatric Medicine Obstetrics & Gynecology Aritha G Francis, NP-C Jill M Thompson, CNM Cumberland Medical Office Medical Center at Gwinnett 2525 Cumberland Parkway, SE 3650 Steve Reynolds Boulevard Atlanta, GA 30339 Duluth, GA 30096 404-365-0966 404-365-0966 Internal Medicine Sandra J Dent, MD Snellville Medical Office 2240 Fountain Drive Snellville, GA 30078 404-365-0966
Medicare Provider Directory Addendum
60691108-G 04/2018
November Additions Deletions
Nephrology Oral & Maxillofacial Surgery Kilsy A Cuello Pichardo, MD Justin M Young, MD, DDS Carroll County Nephrology, PC Atlanta Oral & Facial Surgery, LLC 157 Clinic Avenue, Suite 203 1000 Johnson Ferry Road, Building H Carrollton, GA 30117 Marietta, GA 30068 770-832-0429
770-977-0364
Kilsy A Cuello Pichardo, MD Pediatrics
Carroll County Nephrology, PC Sandra H Armstead, MD 108 Redding Drive Panola Medical Center Bremen, GA 30110 5440 Hillandale Drive 770-832-0429 Lithonia, GA 30058 404-365-0966 Kilsy A Cuello Pichardo, MD Carroll County Nephrology, PC 403 Permian Way, Suite B Villa Rica, GA 30180 770-832-0429 Ashvin R Kamath, MD Georgia Kidney Associates, Inc 55 Witcher Street, Suite 460 Marietta, GA 30060 770-427-7389 Ashvin R Kamath, MD Georgia Kidney Associates, Inc 120 Stonebridge Parkway, Suite 330 Woodstock, GA 30189 770-427-7389 James A Tumlin, MD Georgia Nephrology, LLC 595 Hurricane Shoals Road, NW, Suite 100 Lawrenceville, GA 30046 404-645-7150 Obstetrics & Gynecology Michelle R Martin, MD West Cobb Medical Center 3640 Tramore Parkway Austell, GA 30106 404-365-0966
Medicare Provider Directory Addendum
60691108-G 04/2018
November Additions Deletions
Oncology Paul D Johnson, NP Southwood Medical Center 2400 Mount Zion Parkway Jonesboro, GA 30236 404-365-0966 Paul D Johnson, NP TownPark Medical Center 750 TownPark Lane Kennesaw, GA 30144 404-365-0966 Oral & Maxillofacial Surgery Jonathan M C Threadgill, DMD Atlanta Oral & Facial Surgery, LLC 1000 Johnson Ferry Road, Building H Marietta, GA 30068 770-977-0364 Jonathan M C Threadgill, DMD Atlanta Oral & Facial Surgery, LLC 81 Northside Dawson Drive, Suite 300 Dawsonville, GA 30534 706-265-1274
Medicare Provider Directory Addendum
60691108-G 04/2018
October Additions Deletions
Behavioral Health Internal Medicine Rebekah F Woolery, LCSW Deanna M Del Mazo, MD Cumberland Medical Office Sandy Springs Medical Office 2525 Cumberland Parkway SE 1100 Lake Hearn Drive, NE Atlanta, GA 30339 Atlanta, GA 30342 404-365-0966 404-365-0966 Dermatology Obstetrics & Gynecology Evan W Piette, MD Mercy B Manga, CNP Southwood Specialty Center Southwood Medical Center 2470 Mount Zion Parkway 2400 Mount Zion Parkway Jonesboro, GA 30236 Jonesboro, GA 30236 404-365-0966 404-365-0966 Family Medicine Orthopedic Surgery Sindhura Chilakapati, MD Lindsey A Brown, PA-C TownPark Medical Center Medical Center at Gwinnett 750 TownPark Lane NW 3650 Steve Reynolds Boulevard Kennesaw, GA 30144 Duluth, GA 30096 404-365-0966 404-365-0966 Obstetrics & Gynecology Psychiatry Vicki L yates, CNM Cascade Medical Office
Candice D Tate, MD Sandy Springs Medical Office
1175 Cascade Parkway, SW 1100 Lake Hearn Drive, NE Atlanta, GA 30311 404-365-0966
Atlanta, GA 30342 404-365-0966
Medicare Provider Directory Addendum
60691108-G 04/2018
October Additions Deletions
Obstetrics & Gynecology Vicki L Yates, CNM Douglasville Medical Office 6875 Douglas Boulevard, Suite A Douglasville, GA 30135 404-365-0966 Optometry Linh T Ta, OD Glenlake Medical Center 20 Glenlake Parkway, NE Atlanta, GA 30328 Pediatric Cardiology Natalie Pitts Kenny, MD Glenlake Medical Center 20 Glenlake Parkway, NE Atlanta, GA 30328 404-365-0966 Natalie Pitts Kenny, MD Sandy Springs Medical Office 1100 Lake Hearn Drive, NE Atlanta, GA 30342 404-365-0966 Psychology Gift C McDougal, PsyD Southwood Medical Center 2400 Mount Zion Parkway Jonesboro, GA 30236 404-365-0966
Medicare Provider Directory Addendum
60691108-G 04/2018
October Additions Deletions
Urology Nazia Q Bandukwala, DO J Gilbert Foster, Jr, MD Spencer I Kozinn, MD Rajesh G Laungani, MD Nathan F Pursifull, MD Matthew Sand, MD William M Scaljon, MD Piedmont Providers, LLC 1800 Howell Mill Road, NW, Suite 500 Atlanta, GA 30318 Nazia Q Bandukwala, DO J Gilbert Foster, Jr, MD Spencer I Kozinn, MD Rajesh G Laungani, MD Nathan F Pursifull, MD Matthew Sand, MD William M Scaljon, MD Piedmont Providers, LLC 275 Collier Road, NW Suite 400 Atlanta, GA 30309 Nazia Q Bandukwala, DO J Gilbert Foster, Jr, MD Spencer I Kozinn, MD Rajesh G Laungani, MD Nathan F Pursifull, MD Matthew Sand, MD William M Scaljon, MD Piedmont Providers, LLC 95 Collier Road, NW, Suite 6025 Atlanta, GA 30309
Medicare Provider Directory Addendum
60691108-G 04/2018
September Additions Deletions
Cardiothoracic Surgery Cardiology Milla, Federico, MD Bergh, Mary Ellen, MD Piedmont Cardiology of Atlanta LLC Heller, Louis I., MD 95 Collier Road, Suite 5015 Lesser, Laurence M., MD Atlanta, GA 30309 Gwinnett Cardiology Services LLC 404-605-5699 755 Walther Road Lawrenceville, GA 30046 Family Medicine 770-962-0399 See-Wah Yam, Jennifer, MD Bergh, Mary Ellen, MD Holly Springs Medical Office Heller, Louis I., MD 684 Sixes Road, Suite 275 Lesser, Laurence M., MD Holly Springs, GA 30115 Gwinnett Cardiology Services LLC 404-365-0966 1700 Tree Lane Road, Suite 170 Snellville, GA 30078 See-Wah Yam, Jennifer, MD 770-979-1200 TownPark Comprehensive Medical Center 750 TownPark Lane NW Heller, Louis I., MD Kennesaw, GA 30144 Gwinnett Cardiology Services LLC 404-365-0966 2005 Prince Avenue Athens, GA 30606 Hadi, Mohammed A., MD 770-962-0399 Stonecrest Medical Center 8011 Mall Parkway Heller, Louis I., MD Lithonia, GA 30038 Gwinnett Cardiology Services LLC 404-365-0966 5667 Peachtree Dunwoody Road, Suite 250 Atlanta, GA 30342 404-252-7618
Medicare Provider Directory Addendum
60691108-G 04/2018
September Additions Deletions
Neurology Cardiology Mazell, Shawnay N., MD Heller, Louis I., MD Tsai, Yi Jou, MD Gwinnett Cardiology Services LLC Glenlake Comprehensive Specialty Center 3885 Pleasant Hill Road, Suite 250 20 Glenlake Parkway NE Duluth, GA 30096 Atlanta, GA 30328 770-497-1413 404-365-0966 Heller, Louis I., MD Mazell, Shawnay N., MD Gwinnett Cardiology Services LLC Gwinnett Comprehensive Specialty Center 4745 Nelson Brogdon Boulevard, Suite 300 3650 Steve Reynolds Boulevard Sugar Hill, GA 30518 Duluth, GA 30096 770-932-5951 404-365-0966 Heller, Louis I., MD Tsai, Yi Jou, MD Gwinnett Cardiology Services LLC TownPark Comprehensive Medical Center 4365 Johns Creek Parkway, Suite 450 750 TownPark Lane Suwannee, GA 30024 Kennesaw, GA 30144 678-417-9873 404-365-0966 Optometry Pediatric Otolaryngology Andersen, Joseph L., OD Aaron, Geoffrey P., MD Barnett, Michael R., OD Pediatric Ear, Nose & Throat of Atlanta, PC Avesis Third Party Administrators Inc. 5461 Meridian Mark Road NE, Suite 130 4319 Lawrenceville Highway, Suite A Atlanta, GA 30342 Lilburn, GA 30047 404-255-2033 770-921-4707 Aaron, Geoffrey P., MD Barker, Kacy W., OD Pediatric Ear, Nose & Throat of Atlanta, PC Avesis Third Party Administrators Inc. 3300 Old Milton Parkway, Suite 275 1000 Towne Center Boulevard, Suite 502 Alpharetta, GA 30005 Pooler, GA 31322 404-255-2033 912-748-1272 Pediatric Surgery Barker, Kacy W., OD Avesis Third Party Administrators Inc. Smith, Alexis D., MD 465 Elma G. Miles Parkway Med-Surg Providers at Children’s LLC Hinesville, GA 31313 5445 Meridian Mark Road NE, Suite 340 912-877-2422 Atlanta, GA 30342 404-785-6895
Medicare Provider Directory Addendum
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September Additions Deletions
Pediatric Surgery Optometry Smith, Alexis D., MD Barker, Kacy W., OD Med-Surg Providers at Children’s LLC Avesis Third Party Administrators Inc. 5461 Meridian Mark Road NE, Suites 200 & 570 1000 Gandy Dancer Atlanta, GA 30342 Richmond Hill, GA 30324 404-785-2490 912-756-3628 404-785-6895 Lawson, Elisabeth, J., OD Smith, Alexis D., MD Avesis Third Party Administrators Inc. Med-Surg Providers at Children’s LLC 1000 Hawthorne Avenue, Suite A 3300 Old Milton Parkway, Suite 225 Athens, GA 30606 Alpharetta, GA 30005 706-543-3599 404-785-6895 Shuster, Richard J., OD Smith, Alexis D., MD Avesis Third Party Administrators Inc. Med-Surg Providers at Children’s LLC 4045 Wetherburn Way 410 Peachtree Parkway, Suite 300 Norcross, GA 30092 Cumming, GA 30041 770-441-1211 404-785-6895 Walker, William B., OD Smith, Alexis D., MD Avesis Third Party Administrators Inc. Med-Surg Providers at Children’s LLC 14045 Abercorn Street, Suite 31 2620 Satellite Boulevard Savannah, GA 31419 Duluth, GA 30096 912-925-0700 404-785-6895 Walker, William B., OD Smith, Alexis D., MD Avesis Third Party Administrators Inc. Med-Surg Providers at Children’s LLC 105 Grand Central Boulevard, Suite 110 2660 Satellite Boulevard Pooler, GA 31322 Duluth, GA 30096 912-450-9200 404-785-6895 Walker, William B., OD Smith, Alexis D., MD Avesis Third Party Administrators Inc. Med-Surg Providers at Children’s LLC 1014 Northside Drive East 1255 Johnson Ferry Road, Suite 2 Statesboro, GA 30458 Marietta, GA 30068 912-764-9147 404-785-6895 Walker, William B., OD Smith, Alexis D., MD Avesis Third Party Administrators Inc. Med-Surg Providers at Children’s LLC 594 South Columbia Avenue, Suite 200 95 Collier Road NW, Suite 5015 Rincon, GA 31326 Atlanta, GA 30309 912-826-0935 404-605-5699
Medicare Provider Directory Addendum
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September Additions Deletions
Pediatric Cardiology Elchuri, Swati V., MD CHOA Multispecialty, LLC 1230 Baxter Street Athens, GA 30606 404-785-2000 Elchuri, Swati V., MD CHOA Multispecialty, LLC 1371 Church Street Extension NE Marietta, GA 30060 404-785-2000 Elchuri, Swati V., MD CHOA Multispecialty, LLC 2660 Satellite Boulevard Duluth, GA 30096 404-785-2000 Elchuri, Swati V., MD CHOA Multispecialty, LLC 2015 Uppergate Drive NE Atlanta, GA 30322 404-785-2000 Singh, Deepti, MD Sibley Heart Center Cardiology 355 Tower Road, Suite 204 Marietta, GA 30060 404-256-2593
Medicare Provider Directory Addendum
60691108-G 04/2018
The provider network may change at any time. You will receive notice when necessary. To get the most up-to-date information about Kaiser Permanente’s network providers in your area, you can visit kp.org/directory or call our Member Service Contact Center at 1-800-476-2167, seven days a week, 8 a.m. to 8 p.m. TTY users should call 711.
Kaiser Permanente is an HMO plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal.