Individual provider Active NPI

Neelima Chennupati, MD

  • Family Medicine Physician
  • Ankeny, IA
National Provider Identifier
1093724460
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33515 Issued in IA
Practice address
1360 NW 18TH St Ste 102
Ankeny, IA 50023-9105
Phone
(515) 875-9730
Fax
(515) 875-9731
NPI assigned
Aug 5, 2006
Last updated
Dec 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33515 IA Primary

Addresses

Primary practice location

1360 NW 18TH St Ste 102
Ankeny, IA 50023-9105

Mailing address

PO Box 424
Des Moines, IA 50302-0424
Phone (515) 875-9925

Other practice location 1

1410 SW Tradition Dr
Ste 120
Ankeny, IA 50023
Phone (515) 875-9040

Other identifiers 1

IdentifierTypeStateIssuer
1209494MedicaidIA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address neelimachennupati@tic.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20100507000768 IA Practitioner - Family Practice 5294863478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Iowa Clinic PCGroup PAC ID 4082513742, 307 clinicians

Practice addresses (Care Compare)

1360 NW 18TH St
Suite 102
Ankeny, IA 50023-9105
Phone (515) 875-9730

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33515IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Iowa Clinic PC Family Medicine CurrentSince Nov 1, 2016 Accepting new patients
The Iowa Clinic, PC CurrentSince Nov 1, 2016 Accepting new patients
Floyd County Memorial Hospital Commission Family Medicine Past Accepting new patients

Locations

1360 NW 18th St
Ste 102
Ankeny, IA 50023
Phone (515) 875-9730

1410 SW Tradition Dr
Ste 120
Ankeny, IA 50023
Phone (515) 875-9040

1005 Pennsylvania Ave
Ste 102A
Ottumwa, IA 52501
Phone (641) 684-2589

7147 Vista Dr
Ste 150
West Des Moines, IA 50266
Phone (515) 875-9255

Interoperability endpoints

  • Direct secure messaging: neelimachennupati@tic.allscriptsdirect.net

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1093724460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020424",
            "telephone_number": "515-875-9925",
            "fax_number": "515-875-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 NW 18TH ST STE 102",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500239105",
            "telephone_number": "515-875-9730",
            "fax_number": "515-875-9731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1410 SW Tradition Dr",
            "address_2": "Ste 120",
            "address_purpose": "LOCATION",
            "city": "Ankeny",
            "state": "IA",
            "postal_code": "50023",
            "country_code": "US",
            "telephone_number": "515-875-9040",
            "fax_number": "515-875-9041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHENNUPATI",
        "first_name": "NEELIMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "33515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1209494",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "neelimachennupati@tic.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1360 NW 18th St Ste 102",
            "city": "Ankeny",
            "state": "IA",
            "country_code": "US",
            "postal_code": "500239074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

Verify at the official NPI Registry.