Christine S Peddapanga, DO

Key facts

NPI

1104434307

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

31630 (MS)

Practice address

2200 Highway 61 N Ste 2400
Vicksburg, MS 39183-8246

Phone

(601) 883-3340

Fax

(601) 661-0984

NPI assigned

Jul 14, 2020

Sex

Female

Sole proprietor

No

Organizations & group practices 10

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.

• Scott Regional Medical Center, Inc Emergency Medicine Physician · Morton, MS · NPI 1639367188
  Medicare reassignment Care Compare group NPD MS
• Vicksburg Clinic LLC Family Medicine Physician · Vicksburg, MS · NPI 1790711158
  Medicare reassignment Care Compare group NPD (past) FAMILY MEDICINE · MS
• Scott Regional Medical Center, Inc. Rural Health Clinic/Center · Morton, MS · NPI 1003166117
  Care Compare group NPD FAMILY MEDICINE
• Scott Regional Medical Center, Inc. Critical Access Hospital · Morton, MS · NPI 1134278435
  Care Compare group
• Scott Regional Medical Center, Inc. Medicare Defined Swing Bed Hospital Unit · Morton, MS · NPI 1639228547
  Care Compare group
• Scott Regional Medical Center, Inc. Rural Health Clinic/Center · Lake, MS · NPI 1932478476
  Care Compare group
• Vicksburg Clinic LLC Rural Health Clinic/Center · Vicksburg, MS · NPI 1790915395
  Care Compare group
• Vicksburg Clinic LLC Rural Health Clinic/Center · Vicksburg, MS · NPI 1861622268
  Care Compare group
• Vicksburg Clinic LLC Surgery Physician · Vidalia, LA · NPI 1629279054
  Care Compare group
• Scott Regional Medical Center, Inc. Rural Health Clinic/Center · Forest, MS · NPI 1679831531
  NPD FAMILY MEDICINE

Hospital & facility affiliations 3

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

• Independent Healthcare Management, Inc. Critical Access Hospital · Forest, MS · NPI 1306909734
  Care Compare affiliation Hospital
• Scott Regional Medical Center, Inc. Critical Access Hospital · Morton, MS · NPI 1134278435
  Care Compare affiliation Hospital
• Vicksburg Healthcare LLC General Acute Care Hospital · Vicksburg, MS · NPI 1215981303
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Family Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vicksburg Clinic LLC (27 clinicians)
Scott Regional Medical Center, Inc. (14 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Scott Regional Hospital · Morton, MS · CCN 251323
• Merit Health River Region Hospital · Vicksburg, MS · CCN 250031
• S E Lackey Memorial Hospital Hospital · Forest, MS · CCN 251300

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 29, 2026.

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1104434307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5392",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393025392",
            "telephone_number": "601-703-9407",
            "fax_number": "601-703-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 HIGHWAY 61 N STE 2400",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838246",
            "telephone_number": "601-883-3340",
            "fax_number": "601-661-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDDAPANGA",
        "first_name": "CHRISTINE",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "31630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Vicksburg, MS · Family Medicine Physician in Mississippi