NPIMap

Individual provider Active NPI

Mudunuri V Raju, M.D.

  • Internal Medicine Physician
  • Easley, SC
National Provider Identifier
1124095484
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20898 Issued in SC
Practice address
200 Fleetwood Dr
Easley, SC 29640
Phone
(864) 442-7200
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 20898 SC
Internal Medicine Physician 207R00000X 20898 SC Primary

Addresses

Primary practice location

200 Fleetwood Dr
Easley, SC 29640

Mailing address

1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6174

Other practice location 1

101 E Wood St
Inpatient Medicine
Spartanburg, SC 29303-3040
Phone (864) 560-6619

Other practice location 2

101 E Wood St
Inpatient Medicine
Spartanburg, SC 29303-3040
Phone (864) 560-6619

Other identifiers 7

IdentifierTypeStateIssuer
1316155112OtherSCGROUP NPI
T48874MedicaidSC
110200011OtherSCRAILROAD MEDICARE
1124095484OtherSCNPI
P00437301OtherSCRAILROAD MEDICARE
GP4690MedicaidSC
P00209467OtherSCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050415000360 SC Practitioner - HospitalistPractitioner - Internal Medicine 8325085889 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

701 Grove Rd
Suite 5
Greenville, SC 29605-4210
Phone (864) 455-4411

Hospital & facility affiliations

  • Prisma Health Laurens County Hospital Hospital, Clinton, SC, CCN 420038
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center CurrentSince Dec 1, 2014 Accepting new patients
Prisma Health University Medical Group Internal Medicine Current Accepting new patients
Apogee Medical Group South Carolina Internal Medicine CurrentSince Aug 1, 2015 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Pelham Medical Center CurrentSince Dec 1, 2014 Accepting new patients
Prisma Health University Medical Group CurrentSince Dec 17, 2018 Accepting new patients
Spartanburg Medical Center Internal Medicine CurrentSince Dec 10, 2016 Accepting new patients
Pelham Medical Center Internal Medicine CurrentSince Dec 1, 2014 Accepting new patients
Spartanburg Medical Center CurrentSince Dec 1, 2014 Accepting new patients
Pelham Medical Center Current Accepting new patients
Prisma Health University Medical Group Internal Medicine CurrentSince Dec 17, 2018 Accepting new patients
Pinnacle Capital Holdings Internal Medicine PastSince Jan 1, 2011 Accepting new patients
Mary Black Physicians Group LLC Internal Medicine Past Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

200 Fleetwood Dr
Easley, SC 29640
Phone (864) 442-7200

1530 N Limestone St
Gaffney, SC 29340
Phone (864) 487-1544

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

701 Grove Rd
#5
Greenville, SC 29605
Phone (864) 455-4411

250 Westmoreland Rd
Greer, SC 29651
Phone (864) 530-2108

1115 Wren School Rd
Piedmont, SC 29673
Phone (864) 859-0740

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

Interoperability endpoints

  • Direct secure messaging: mraju50241@direct.ghs.myhfn.org

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1124095484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FLEETWOOD DR",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "29640",
            "telephone_number": "864-442-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E Wood St",
            "address_2": "Inpatient Medicine",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293033040",
            "country_code": "US",
            "telephone_number": "864-560-6619",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 E Wood St",
            "address_2": "Inpatient Medicine",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293033040",
            "country_code": "US",
            "telephone_number": "864-560-6619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAJU",
        "first_name": "MUDUNURI",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "20898",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "20898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1316155112",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T48874",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110200011",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1124095484",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00437301",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4690",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00209467",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Easley, SC

Sources for this page

Verify at the official NPI Registry.