Gopi K Gundumalla, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

35.094522 Issued in OH

Practice address

4439 State Route 159
Ste 204
Chillicothe, OH 45601-8207

Phone

(740) 779-8728

Fax

(740) 779-8729

NPI assigned

Jan 27, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hospital Medicine Services of Tennessee PC

  • Hospitalist Physician
  • Lawrenceburg, IN
  • NPI 1528433802

  KY

  Medicare reassignment NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  KY

  Medicare reassignment NPD

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1003887381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4439 STATE ROUTE 159",
            "address_2": "STE 204",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456018207",
            "telephone_number": "740-779-8728",
            "fax_number": "740-779-8729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4439 STATE ROUTE 159",
            "address_2": "STE 204",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456018207",
            "telephone_number": "740-779-8728",
            "fax_number": "740-779-8729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDUMALLA",
        "first_name": "GOPI",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "KY",
            "license": "36942",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35.094522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810016457",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64053077",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3011314",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaley Lynn Guendouz, APRN, CNP
• Jenny Lee Guest, DO
• Waheed Gul, MD
• Elizabeth Gumm
• Elizabeth Eileen Gump, LSW
• Kamille Guthery, MSW
• Sarah Jane Gutridge, DPT
• Charles Haas
• Hunter Hackworth
• Lisa Fay Hackworth

• Nephrology Physician in Chillicothe, OH
• Providers in Chillicothe, OH by specialty
• Nephrology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; 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.