Active NPI
Ratnam Baby Nagalla, M.D
- Pediatrics Physician
- Shreveport, LA
National Provider Identifier
1013042985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD.03803R
- Practice address
- 870 Olive St
Shreveport, LA 71104-2159 - Phone
- (318) 629-0480
- Fax
- (318) 629-0483
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD.03803R | LA | |
| Pediatrics Physician | 208000000X | MD.03803R | LA | Primary |
Addresses
Primary practice location
870 Olive St
Shreveport, LA 71104-2159
Mailing address
870 Olive St
Shreveport, LA 71104-2159
Phone (318) 629-0480
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1152609 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD.03803R | LA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CLHG-Winn, LLC | Family Medicine | Past | Accepting new patients |
| Winnfield Family Practice, L.L.C | Family Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Winnfield, LA
- NPI 1629391628
-
- Family Medicine Physician
- Winnfield, LA
- NPI 1154512853
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353283200000",
"number": "1013042985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "870 OLIVE ST",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711042159",
"telephone_number": "318-629-0480",
"fax_number": "318-629-0483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "870 OLIVE ST",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711042159",
"telephone_number": "318-629-0480",
"fax_number": "318-629-0483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAGALLA",
"first_name": "RATNAM",
"middle_name": "BABY",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2012-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "LA",
"license": "MD.03803R",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "LA",
"license": "MD.03803R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1152609",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.