Individual provider Active NPI

Anusha Reddy Gaddam, MD

  • Family Medicine Physician
  • Sanford, NC
National Provider Identifier
1174192207
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2024-01025 Issued in NC
Practice address
2919 Beechtree Dr
Suite 1120
Sanford, NC 27330-6934
Phone
(919) 897-2256
Fax
(919) 897-2261
NPI assigned
Jun 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2024-01025 NC Primary

Addresses

Primary practice location

2919 Beechtree Dr
Suite 1120
Sanford, NC 27330-6934

Mailing address

2919 Beechtree Dr
Suite 1120
Sanford, NC 27330-6934
Phone (919) 897-2256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240620000240 NC Practitioner - Family Practice 4284177163 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
FHPG, LLC Family Medicine Current Accepting new patients
FHPG, LLC Family Medicine CurrentSince Jun 3, 2024 Accepting new patients
FHPG, LLC Family Medicine CurrentSince Jun 3, 2024 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1174192207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 BEECHTREE DR",
            "address_2": "SUITE 1120",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273306934",
            "telephone_number": "919-897-2256",
            "fax_number": "919-897-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 BEECHTREE DR",
            "address_2": "SUITE 1120",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273306934",
            "telephone_number": "919-897-2256",
            "fax_number": "919-897-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDAM",
        "first_name": "ANUSHA",
        "middle_name": "REDDY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2025-03-13",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2024-01025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

Verify at the official NPI Registry.