Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mini Joseph Shivprasad, MD

Individual provider Geriatric Medicine (Internal Medicine) Physician · NPI 1407836158

Mini Joseph Shivprasad, MD is a Geriatric Medicine in Gainesville, Georgia. Qualified in 1994, 32 years ago. Practices with Northeast Georgia Diagnostic Associates and Clinic, LLC, a 81-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
32
Licensed in
GA
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1240 Jesse Jewell Pkwy SE Ste 500
Gainesville, GA 30501-3862
Phone: (770) 536-9864
Fax: (770) 297-5023
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 57493 (GA)
Geriatric Medicine (Internal Medicine) Physician Taxonomy 207RG0300X · Licence 57493 (GA)

Record details

NPI number1407836158
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 19, 2006
Last updated in NPPESMarch 9, 2021
Certification dateMarch 9, 2021
Mailing address1240 Jesse Jewell Pkwy Se, Suite 500, Gainesville, GA 30501-3862

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGERIATRIC MEDICINE
Also practisesINTERNAL MEDICINE
Medical schoolOTHER
Graduated 1994 (32 years in practice)
Group practice Northeast Georgia Diagnostic Associates And Clinic, Llc — 81 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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