Active NPI
Vivekananda Varma Datla, M.D.,
- Hospitalist Physician
- Ashland, KY
National Provider Identifier
1154524148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 43412
- Practice address
- 2201 Lexington Ave
Ashland, KY 41101-2843 - Phone
- (606) 408-4000
- Fax
- (606) 408-6825
- NPI assigned
- Jun 7, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | 43412 | KY | |
| Hospitalist Physician | 208M00000X | 43412 | KY | Primary |
Addresses
Primary practice location
2201 Lexington Ave
Ashland, KY 41101-2843
Mailing address
PO Box 2379
Ashland, KY 41105-2379
Phone (606) 408-6200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3066524 | Medicaid | OH | |
| 7100129360 | Medicaid | KY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | vdatla25251@direct.kdhealth.us | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2201 Lexington Ave
Ashland, KY 41101-2843
Phone (606) 408-4000
Hospital & facility affiliations
- King'S Daughters' Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.04 of 100
- Quality
- 60.55
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 78.81
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43412 | KY | MD | Adult Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kings Daughters Medical Specialties Inc., | Current | Accepting new patients | |
| Kings Daughters Medical Specialties Inc | Current | Accepting new patients | |
| Kings Daughters Medical Specialties Inc | Current | Accepting new patients | |
| Ashland Hospital Corporation | Past | Accepting new patients |
Locations
2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560
Interoperability endpoints
- vdatla25251@direct.kdhealth.us
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.
-
- Physical Medicine & Rehabilitation Physician
- Prestonsburg, KY
- NPI 1710215736
-
- Radiation Oncology Physician
- Ashland, KY
- NPI 1699565176
-
- Podiatrist
- Ashland, KY
- NPI 1528502200
-
- General Acute Care Hospital
- Ashland, KY
- NPI 1851346720
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Ashland, KY
- NPI 1851346720
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652832000000",
"number": "1154524148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2379",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411052379",
"telephone_number": "606-408-6200",
"fax_number": "606-408-6612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 LEXINGTON AVE",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411012843",
"telephone_number": "606-408-4000",
"fax_number": "606-408-6825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DATLA",
"first_name": "VIVEKANANDA",
"middle_name": "VARMA",
"credential": "M.D.,",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-07",
"last_updated": "2022-05-18",
"certification_date": "2022-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "KY",
"license": "43412",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "KY",
"license": "43412",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3066524",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100129360",
"state": "KY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "vdatla25251@direct.kdhealth.us",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Eamil",
"address_1": "2201 Lexington Ave",
"city": "Ashland",
"state": "KY",
"country_code": "US",
"postal_code": "411012843",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Ashland, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.