Individual provider Active NPI

Sowjanya Mukkamala

  • Physical Therapist
  • Ripley, WV
National Provider Identifier
1083382386
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT004425 Issued in WV
Practice address
420 Charleston Dr Ste a
Ripley, WV 25271-1714
Phone
(304) 373-0093
NPI assigned
Sep 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT004425 WV Primary

Addresses

Primary practice location

420 Charleston Dr Ste a
Ripley, WV 25271-1714

Mailing address

415 36TH St Ste 100
Parkersburg, WV 26101-1005
Phone (304) 917-3660

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211213001189 WV Practitioner - Physical Therapist in Private Practice 9739579418 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
West Virginia University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Settlement Physical TherapyGroup PAC ID 7113914631, shared by 5 NPIs, 97 clinicians

Practice addresses (Care Compare)

1001 Bridge Rd
Charleston, WV 25314-1305
Phone (304) 759-8428

313 Maccorkle Ave SW
South Charleston, WV 25303-1263
Phone (304) 746-3704

Merit-based Incentive Payment System (MIPS)

Final score
87.35 of 100Reported as group
Quality
87.12
Promoting interoperability
100
Improvement activities
40
Cost
70.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
First Settlement Physical Therapy Physical Therapist CurrentSince Jun 1, 2022 Accepting new patients
First Settlement Physical Therapy Physical Therapist Current Accepting new patients
First Settlement Physical Therapy Physical Therapist CurrentSince Jun 1, 2022 Accepting new patients

Locations

2434 Richmiller Ln
Unit B
Belpre, OH 45714
Phone (740) 423-1500

1001 Bridge Rd
Charleston, WV 25314
Phone (304) 759-8428

2837 Pike St
#A
Parkersburg, WV 26101
Phone (304) 489-2230

240 Washington St
Ravenswood, WV 26164
Phone (304) 273-8071

313 Maccorkle Ave SW
South Charleston, WV 25303
Phone (304) 744-2300

1500 Grand Central Ave
Ste 101
Vienna, WV 26105
Phone (304) 295-3060

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1083382386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 36TH ST STE 100",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261011005",
            "telephone_number": "304-917-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 CHARLESTON DR STE A",
            "city": "RIPLEY",
            "state": "WV",
            "postal_code": "252711714",
            "telephone_number": "304-373-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKKAMALA",
        "first_name": "SOWJANYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "PT004425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ripley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.