Individual provider Active NPI

Vani Kudlur Chandrappa, M.D.

  • Pediatrics Physician
  • Olive Branch, MS
National Provider Identifier
1124329016
Registry record updated Oct 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
49385 Issued in TN
Practice address
5480 Goodman Rd
Olive Branch, MS 38654-7902
Phone
(662) 893-9877
NPI assigned
Nov 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 49385 TN Primary

Addresses

Primary practice location

5480 Goodman Rd
Olive Branch, MS 38654-7902

Mailing address

9871 Garden PL
Germantown, TN 38139-6934

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
49385TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
All Children'S Clinic,PC Pediatrics Past Accepting new patients
Memphis Radiological, PC Past Accepting new patients
Baptist Memorial Hospital-Desoto, Inc, Past Accepting new patients
Methodist Healthcare - Olive Branch Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: vchandrappa34681@mlh.direct-ci.com
  • Direct secure messaging: vani.chandrappa.1@14999.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14999/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412553600000",
    "number": "1124329016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9871 GARDEN PL",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381396934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 GOODMAN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386547902",
            "telephone_number": "662-893-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDLUR CHANDRAPPA",
        "first_name": "VANI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-08",
        "last_updated": "2014-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "49385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; 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.