Individual provider Active NPI

Sai Lakshmi Pallimalli, MD

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1093047664
Registry record updated Jun 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
201401605 Issued in NC
Practice address
2620 E 7TH St
Suite 100
Charlotte, NC 28204-4381
Phone
(704) 332-7141
Fax
(704) 342-3324
NPI assigned
Feb 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 201401605 NC Primary

Addresses

Primary practice location

2620 E 7TH St
Suite 100
Charlotte, NC 28204-4381

Mailing address

PO Box 647
Hope Mills, NC 28348-0647
Phone (910) 483-7337

Other identifiers 9

IdentifierTypeStateIssuer
1093047664MedicaidNC
13477037OtherNCPHCS/MULTIPLAN
260610OtherNCMEDCOST
5881053OtherNCUNITED HEALTHCARE
6035671OtherNCCIGNA/GREATWEST
19GJVOtherNCBCBS OF NC
1093047664OtherNCHUMANA
9545505OtherNCAETNA
FH1101985OtherNCFIRST CAROLINA CARE

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
I20240301003105 NC Practitioner - Pediatric Medicine 5698110427 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201401605NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Regional Health Network CurrentSince Jun 28, 2024 Accepting new patients
Carolinas Physicians Network Inc Pediatrics CurrentSince Mar 11, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Mar 11, 2024 Accepting new patients
Healthy Kidz Pediatrics Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Columbus Regional Health Network Current Accepting new patients
Columbus Regional Health Network Pediatrics CurrentSince Jun 28, 2024 Accepting new patients
Kidzcare Pediatrics, PC Pediatrics Past Accepting new patients
Snitz Pediatrics Past Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients
Columbus Regional Health Network Past Accepting new patients

Locations

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

6030 W Highway 74
Ste F
Indian Trail, NC 28079
Phone (704) 246-2900

3173 W Highway 74
Monroe, NC 28110
Phone (704) 283-2000

612 Jefferson St
#28
Whiteville, NC 28472
Phone (910) 640-4064

36 McNeill Plz
Whiteville, NC 28472
Phone (910) 640-4064

Interoperability endpoints

  • Direct secure messaging: spallimalli2742074@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: sai@healthykidz.azalea.phimailbox.com

Organizations & group practices 11

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": "1265587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1093047664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 647",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283480647",
            "telephone_number": "910-483-7337",
            "fax_number": "910-483-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 E 7TH ST",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044381",
            "telephone_number": "704-332-7141",
            "fax_number": "704-342-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLIMALLI",
        "first_name": "SAI",
        "middle_name": "LAKSHMI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-08",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "201401605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093047664",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS/MULTIPLAN",
            "identifier": "13477037",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "260610",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "5881053",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA/GREATWEST",
            "identifier": "6035671",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "19GJV",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "1093047664",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9545505",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CAROLINA CARE",
            "identifier": "FH1101985",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.