Active NPI
Sree Chellappan, MD
- Family Medicine Physician
- Pine Bluff, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0101281549
- Practice address
- 1601 W 40TH Ave Ste 100
Pine Bluff, AR 71603-6069 - Phone
- (870) 541-6000
- Fax
- (870) 541-6010
- NPI assigned
- Apr 20, 2020
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101281549 | VA | Primary |
| Family Medicine Physician | 207Q00000X | E-15648 | AR | |
| Emergency Medicine Physician | 207P00000X | E15648 | AR |
Addresses
Primary practice location
1601 W 40TH Ave Ste 100
Pine Bluff, AR 71603-6069
Mailing address
200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7101 Jahnke Rd
Richmond, VA 23225-4017
Phone (804) 320-3911
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E15648 | AR | MD | Emergency Medicine Physician |
| E-15648 | AR | MD | Family Medicine Physician |
| 0101281549 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Intensivist Services PC | Current | Accepting new patients | |
| Family Practice Associates of Clarksville,PA | Past | Accepting new patients |
Locations
1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046
7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088
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.
-
- Legal Medicine
- Clarksville, AR
- NPI 1518957240
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Richmond, VA
- NPI 1598708513
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726444800000",
"number": "1073133179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 CORPORATE BLVD",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705083870",
"telephone_number": "800-893-9698",
"fax_number": "870-541-6010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 W 40TH AVE STE 100",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716036069",
"telephone_number": "870-541-6000",
"fax_number": "870-541-6010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHELLAPPAN",
"first_name": "SREE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-20",
"last_updated": "2024-09-16",
"certification_date": "2024-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0101281549",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "E-15648",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "AR",
"license": "E15648",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pine Bluff, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.