Active NPI
Giridhar Venkatraman, M.D.
- Otolaryngology Physician
- Lebanon, NH
National Provider Identifier
1124217070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 13727
- Practice address
- 1 Medical Center Dr
Lebanon, NH 03756-1000 - Phone
- (603) 650-5174
- NPI assigned
- Oct 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 13727 | NH | Primary |
Addresses
Primary practice location
1 Medical Center Dr
Lebanon, NH 03756-1000
Mailing address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 650-5174
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1014257 | Medicaid | VT | |
| 30207221 | Medicaid | NH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13727 | NH | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317254400000",
"number": "1124217070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"city": "LEBANON",
"state": "NH",
"postal_code": "037561000",
"telephone_number": "603-650-5174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"city": "LEBANON",
"state": "NH",
"postal_code": "037561000",
"telephone_number": "603-650-5174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENKATRAMAN",
"first_name": "GIRIDHAR",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-16",
"last_updated": "2011-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NH",
"license": "13727",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1014257",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30207221",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.