Sai Kiran Gudla

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

LL89748 Issued in SC

Practice address

169 Ashley Ave RM 202
Charleston, SC 29425-2134

Phone

(843) 792-2575

NPI assigned

Mar 28, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1003566498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11522 TURNING HAWK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE RM 202",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294252134",
            "telephone_number": "843-792-2575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 S Kings Dr Fl 3",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUDLA",
        "first_name": "SAI KIRAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "LL89748",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincent Paul Grzywacz II, MD
• Sally Ling Guan, PHARMD
• Guardian Pharmacy of South Carolina One
• Alexander Stefano Guareschi
• Charles J Gudas, DPM
• Kristine Theresa Guerin, ACNP
• Kelly S Guerrero, PA
• Lisa Marie Guerrino, DMD
• Sarah Guerry
• Alexis Angel Lagtapon Guevara, MD

• Diagnostic Radiology Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Diagnostic Radiology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.