Kondal Rao Madaram, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2015-01900 Issued in NC

Practice address

1705 Tarboro St SW
Wilson, NC 27893-3428

Phone

(252) 399-7057

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, WA, AZ, NM, MT, OR, DE7 enrollments

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 7

Specialty

Psychiatry

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Alamance Regional Medical Center IncGroup PAC ID 5294647145, 71 clinicians

Recovery Innovations IncGroup PAC ID 1456500628, shared by 8 NPIs, 54 clinicians

Holly Hill Hospital LLCGroup PAC ID 7810806650, 10 clinicians

Freedom Psychiatry Services PLLCGroup PAC ID 9931442704, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 32)

Networks

• devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
• devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1
• TN PPO C-SNP
• devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
• TN PPO

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.

• Freedom Psychiatry Services PLLC

  • Child & Adolescent Psychiatry Physician
  • Raleigh, NC
  • NPI 1699279448
  Medicare reassignment Care Compare group Authorized official
• Alamance Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Burlington, NC
  • NPI 1326010273
  Medicare reassignment Care Compare group NPD
• Holly Hill Hospital LLC

  dba Holly Hill Hospital

  • Psychiatric Hospital
  • Raleigh, NC
  • NPI 1518037233

  Psychiatry

  Medicare reassignment Care Compare group NPD
• DLP Maria Parham Physician Practices, LLC

  dba Maria Parham Primary Care

  • Family Medicine Physician
  • Henderson, NC
  • NPI 1215273628
  Medicare reassignment NPD
• DLP Wilson Physician Practices LLC

  • Family Medicine Physician
  • Wilson, NC
  • NPI 1932521010
  Medicare reassignment NPD
• Recovery Innovations, Inc

  dba Ri International

  • Community/Behavioral Health Agency
  • Durham, NC
  • NPI 1700257664
  Medicare reassignment NPD
• The Moses H. Cone Memorial Hospital Operating Corporation

  dba Cone Health Sickle Cell Center

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1013265909
  Medicare reassignment NPD
• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment NPD
• Bozeman Health Deaconess Hospital

  • Family Medicine Physician
  • Bozeman, MT
  • NPI 1619347390
  Medicare reassignment NPD
• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  Family Medicine

  Medicare reassignment NPD
• Legacy Salmon Creek Hospital

  dba Legacy Salmon Creek Providers

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784
  Medicare reassignment NPD
• Memorial Hospital Association

  dba Beartooth Billings Clinic

  • Primary Care Clinic/Center
  • Red Lodge, MT
  • NPI 1184785099
  Medicare reassignment NPD

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1003952144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 COOPER BLUFF PL",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275190123",
            "telephone_number": "919-271-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 TARBORO ST SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933428",
            "telephone_number": "252-399-7057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 S Columbia Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582014032",
            "country_code": "US",
            "telephone_number": "701-780-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11405 Bob Findlay Rd E",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984453715",
            "country_code": "US",
            "telephone_number": "602-650-1212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11361 N 99th Ave Ste 400&402",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853455470",
            "country_code": "US",
            "telephone_number": "602-650-1212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 S Meridian",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983716995",
            "country_code": "US",
            "telephone_number": "602-650-1212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14554 Lee Rd",
            "address_purpose": "LOCATION",
            "city": "Chantilly",
            "state": "VA",
            "postal_code": "201511775",
            "country_code": "US",
            "telephone_number": "804-215-3940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1850 Copper Loop Ste B",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880058141",
            "country_code": "US",
            "telephone_number": "575-449-8159",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2150 Freeman Rd E",
            "address_purpose": "LOCATION",
            "city": "Fife",
            "state": "WA",
            "postal_code": "984243776",
            "country_code": "US",
            "telephone_number": "602-650-1212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2801 N Gantenbein Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271623",
            "country_code": "US",
            "telephone_number": "503-413-8949",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "915 Highland Blvd",
            "address_purpose": "LOCATION",
            "city": "Bozeman",
            "state": "MT",
            "postal_code": "597156902",
            "country_code": "US",
            "telephone_number": "406-414-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADARAM",
        "first_name": "KONDAL",
        "middle_name": "RAO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD434924",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2015-01900",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MT",
            "license": "144502",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD60804825",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "2015-01900",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "ND",
            "license": "11373",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luv -N- Care
• Luv N Care Health Services
• Luxottica Retail North America Inc (Sears Optical #C1075)
• Lynn Hutchins Psychiatric Nurse
• Serena Louise Macdonald, MD
• Madip Homes, Inc
• Shelley Marie Caro Magsino, NP
• Sasan Mahmoudi, MD
• Ai Vy Thi Mai
• Making Changes Inc.

• Psychiatry Physician in Wilson, NC
• Providers in Wilson, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.