Individual provider Active NPI

Venugopal Naidu Gadipudi, M.D.

  • Neurology Physician
  • Fayetteville, NC
National Provider Identifier
1073518494
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
200400863 Issued in NC
Practice address
2500 Village Dr
Ste 102
Fayetteville, NC 28304-3811
Phone
(910) 484-0029
Fax
(910) 484-0275
NPI assigned
Jun 14, 2005
Last updated
Aug 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 200400863 NC Primary

Addresses

Primary practice location

2500 Village Dr
Ste 102
Fayetteville, NC 28304-3811

Mailing address

601 Brisbane CT
Fayetteville, NC 28314-2549
Phone (910) 728-1090

Other identifiers 4

IdentifierTypeStateIssuer
891375AMedicaidNC
561775962OtherNCTRICARE
13754AOtherNCBCBS
561775962OtherNCCOMMERICAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20041104000507 NC Practitioner - Neurology 9335034784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians

Practice addresses (Care Compare)

2500 Village Dr
Fayetteville, NC 28304-3982
Phone (910) 484-0029

721 Tilghman Dr
Dunn, NC 28334-6066
Phone (910) 892-5635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Neurology Associates, PLLC Neurology CurrentSince Oct 1, 2005 Accepting new patients
Broome Neurosciences, P C PastSince Oct 9, 1997 Accepting new patients
Cape Fear Neurology Associates PA Past Accepting new patients

Locations

2500 Village Dr
Ste 102
Fayetteville, NC 28304
Phone (910) 484-0029

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22662/brand/1/csg/1/fhir/r4
  • Direct secure messaging: venugopal.gadipudi.1@22662.direct.athenahealth.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1073518494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 BRISBANE CT",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283142549",
            "telephone_number": "910-728-1090",
            "fax_number": "910-484-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 VILLAGE DR",
            "address_2": "STE 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043811",
            "telephone_number": "910-484-0029",
            "fax_number": "910-484-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADIPUDI",
        "first_name": "VENUGOPAL",
        "middle_name": "NAIDU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "200400863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891375A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "561775962",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "13754A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERICAL",
            "identifier": "561775962",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.