Individual provider Active NPI

Ramasubbareddy Dhanireddy, MD

  • Neonatal-Perinatal Medicine Physician
  • Memphis, TN
National Provider Identifier
1144287863
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
39709 Issued in TN
Practice address
853 Jefferson Ave
Rout Center for Women and Newborns, Suite 201
Memphis, TN 38103-2807
Phone
(901) 448-5950
Fax
(901) 448-1691
NPI assigned
Apr 27, 2006
Last updated
Oct 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 39709 TN Primary

Addresses

Primary practice location

853 Jefferson Ave
Rout Center for Women and Newborns, Suite 201
Memphis, TN 38103-2807

Mailing address

66 N Pauline St
Suite 206
Memphis, TN 38105-5105
Phone (901) 448-7642

Other identifiers 7

IdentifierTypeStateIssuer
003179455AMedicaidGA
1144287863MedicaidMI
1144287863MedicaidMO
5440538MedicaidTN
177903MedicaidAL
09151257MedicaidMS
140941001MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060724000342 TN Practitioner - Pediatric Medicine 5597778258 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39709TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Medical Group, Inc. CurrentSince Jun 23, 2010 Accepting new patients
Ut Medical Group Inc Neonatal-Perinatal Medicine CurrentSince Jun 23, 2010 Accepting new patients
Methodist Healthcare Primary Care Associates Past Accepting new patients

Locations

853 Jefferson Ave
Ste 201
Memphis, TN 38103
Phone (901) 448-4750

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1144287863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 N PAULINE ST",
            "address_2": "SUITE 206",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381055105",
            "telephone_number": "901-448-7642",
            "fax_number": "901-448-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 JEFFERSON AVE",
            "address_2": "ROUT CENTER FOR WOMEN AND NEWBORNS, SUITE 201",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807",
            "telephone_number": "901-448-5950",
            "fax_number": "901-448-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHANIREDDY",
        "first_name": "RAMASUBBAREDDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TN",
            "license": "39709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003179455A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144287863",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144287863",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5440538",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177903",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09151257",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140941001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.