Individual provider Active NPI

Shridevi Karikehalli, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Utica, NY
National Provider Identifier
1114000437
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
264820 Issued in NY
Practice address
1656 Champlin Avenue
Pathology Department. St. Lukes Hospital Campus
Utica, NY 13502
Phone
(315) 624-8244
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 264820 NY Primary

Addresses

Primary practice location

1656 Champlin Avenue
Pathology Department. St. Lukes Hospital Campus
Utica, NY 13502

Mailing address

1656 Champlin Avenue
Pathology Department. St. Lukes Hospital Campus
Utica, NY 13502

Other identifiers 1

IdentifierTypeStateIssuer
03164321MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
264820NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1114000437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1656 CHAMPLIN AVENUE",
            "address_2": "PATHOLOGY DEPARTMENT. ST. LUKES HOSPITAL CAMPUS",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "13502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1656 CHAMPLIN AVENUE",
            "address_2": "PATHOLOGY DEPARTMENT. ST. LUKES HOSPITAL CAMPUS",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "13502",
            "telephone_number": "315-624-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARIKEHALLI",
        "first_name": "SHRIDEVI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "264820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03164321",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.