Individual provider Active NPI

Vanaja Thondapu, MD

  • Internal Medicine Physician
  • Coralville, IA
National Provider Identifier
1013917558
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
28489 Issued in IA
Practice address
105 E 9TH St
Coralville, IA 52241
Phone
(319) 467-2000
Fax
(319) 467-2505
NPI assigned
Jul 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 28489 IA Primary

Addresses

Primary practice location

105 E 9TH St
Coralville, IA 52241

Mailing address

105 E 9TH St
Coralville, IA 52241-2209
Phone (319) 467-2000

Other practice location 1

5409 Avenue O
Fort Madison, IA 52627-9601
Phone (319) 376-2134

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

LicenseStateTypeSpecialty
28489IAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Iowa Regional Medical Center, Inc. Past Accepting new patients
Ozarks Medical Center 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.

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1013917558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 E 9TH ST",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412209",
            "telephone_number": "319-467-2000",
            "fax_number": "319-467-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E 9TH ST",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "52241",
            "telephone_number": "319-467-2000",
            "fax_number": "319-467-2505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5409 Avenue O",
            "address_purpose": "LOCATION",
            "city": "Fort Madison",
            "state": "IA",
            "postal_code": "526279601",
            "country_code": "US",
            "telephone_number": "319-376-2134",
            "fax_number": "319-376-2188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THONDAPU",
        "first_name": "VANAJA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-27",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "28489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coralville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.