Individual provider Active NPI

Krishna Dummula, M.D., M.P.H.

  • Neonatal-Perinatal Medicine Physician
  • Kansas City, KS
National Provider Identifier
1154530525
Registry record updated Apr 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
0434005 Issued in KS
Practice address
3901 Rainbow Blvd
Mail Stop: 4004
Kansas City, KS 66103-2937
Phone
(913) 588-6337
Fax
(913) 588-6317
NPI assigned
May 22, 2007
Last updated
Apr 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0434005 KS
Neonatal-Perinatal Medicine Physician 2080N0001X 0434005 KS Primary

Addresses

Primary practice location

3901 Rainbow Blvd
Mail Stop: 4004
Kansas City, KS 66103-2937

Mailing address

3901 Rainbow Blvd
Mail Stop: 4004
Kansas City, KS 66103-2937
Phone (913) 588-6337

Other identifiers 3

IdentifierTypeStateIssuer
032A00020OtherKSMEDICARE PTAN (INDIVIDUAL)
200654260AMedicaidKS
0320000AOtherKSMEDICARE PTAN (GROUP)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20100727001002 KS Practitioner - Pediatric Medicine 4486787462 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0434005KSMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Pediatrics Current Accepting new patients
University of Kansas Hospital Authority CurrentSince Jul 13, 2013 Accepting new patients
Kansas University Physicians Inc CurrentSince Jul 1, 2010 Accepting new patients
University of Kansas Hospital Authority CurrentSince Jul 13, 2013 Accepting new patients
Kansas University Physicians Inc CurrentSince Jul 1, 2010 Accepting new patients
The Children's Mercy Hospital Past Accepting new patients
University of Kansas Hospital Authority Past Accepting new patients

Locations

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

3901 Rainbow Blvd
Stop 4004
Kansas City, KS 66160
Phone (913) 588-6301

Interoperability endpoints

  • Direct secure messaging: kdummula23823@direct.kuha.org

Organizations & group practices 7

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303948800000",
    "number": "1154530525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "address_2": "MAIL STOP: 4004",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661032937",
            "telephone_number": "913-588-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "address_2": "MAIL STOP: 4004",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661032937",
            "telephone_number": "913-588-6337",
            "fax_number": "913-588-6317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMMULA",
        "first_name": "KRISHNA",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2011-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "0434005",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "KS",
            "license": "0434005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "032A00020",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200654260A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "0320000A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.