Padmaja Devi Adusumilli, MD
Individual provider Active NPI Internal Medicine Physician · Leavenworth, KS
NPI 1144288168 · NPPES record last updated Jun 4, 2008
Key facts
- NPI
- 1144288168
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 04-31169 (KS)
- Practice address
- 4101 S 4TH St
Leavenworth, KS 66048-5014 - Phone
- (913) 682-2000
- Fax
- (913) 758-4119
- NPI assigned
- May 1, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150514000152 | MO | Order and Referring Only - Internal Medicine |
5890964597 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-31169 | KS | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 04-31169 | KS | Yes |
Addresses
Primary practice location
4101 S 4TH St
Leavenworth, KS 66048-5014
Mailing address
4101 S 4TH St
Leavenworth, KS 66048-5014
Phone (913) 682-2000
Other names
- Padmaja Devi Ghanta
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All providers in Leavenworth, KS · Internal Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.