Individual provider Active NPI

Nalini Chakravarthy, MD

  • Pediatrics Physician
  • Livonia, MI
National Provider Identifier
1144282799
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
NC075540 Issued in MI
Practice address
37595 7 Mile Rd
Suite 420
Livonia, MI 48152-1003
Phone
(734) 459-7444
Fax
(734) 459-7755
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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 NC075540 MI Primary

Addresses

Primary practice location

37595 7 Mile Rd
Suite 420
Livonia, MI 48152-1003

Mailing address

Dept 77913
PO Box 77000
Detroit, MI 48272-0001
Phone (734) 459-7444

Other identifiers 2

IdentifierTypeStateIssuer
300163180OtherMITAX ID
4534292MedicaidMI

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
NC075540MIMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292284800000",
    "number": "1144282799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 77913",
            "address_2": "PO BOX 77000",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482720001",
            "telephone_number": "734-459-7444",
            "fax_number": "734-459-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37595 7 MILE RD",
            "address_2": "SUITE 420",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521003",
            "telephone_number": "734-459-7444",
            "fax_number": "734-459-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAKRAVARTHY",
        "first_name": "NALINI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2010-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "NC075540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "300163180",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4534292",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.