Individual provider Active NPI

Rajasekhar Kannali, M.D.

  • Psychiatry Physician
  • Charlotte, NC
National Provider Identifier
1174879415
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2017-00073 Issued in NC
Practice address
1900 Randolph Rd Ste 800
Charlotte, NC 28207-1110
Phone
(704) 384-1246
NPI assigned
Jul 24, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 126916 OH
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 2017-00073 NC Primary

Addresses

Primary practice location

1900 Randolph Rd Ste 800
Charlotte, NC 28207-1110

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-1246

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rkannali438314@direct.novanthealth.org

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
I20170807000814 NC Practitioner - Psychiatry 6608018700 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

9929 Rea Rd
Suite 101
Waxhaw, NC 28173-6421
Phone (704) 316-1075

Hospital & facility affiliations

  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
126916OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Multi-Specialty CurrentSince Apr 9, 2022 Accepting new patients
Forsyth Memorial Hospital, Inc. Multi-Specialty Current Accepting new patients
Cabarrus Rowan Community Health Centers, Inc. Multi-Specialty CurrentSince Aug 10, 2019 Accepting new patients
Forsyth Memorial Hospital, Inc. Multi-Specialty CurrentSince Jan 15, 2021 Accepting new patients
Forsyth Memorial Hospital Inc Multi-Specialty CurrentSince Jan 15, 2021 Accepting new patients
Novant Health Medical Group, LLC Multi-Specialty Current Accepting new patients
Cabarrus Rowan Community Health Centers, Inc. CurrentSince Aug 10, 2019 Accepting new patients
Cabarrus Rowan Community Health Centers, Inc. Multi-Specialty Current Accepting new patients
Novant Health Medical Group, LLC Multi-Specialty CurrentSince Apr 9, 2022 Accepting new patients
The Presbyterian Hospital Past Accepting new patients

Locations

1900 Randolph Rd
Ste 800
Charlotte, NC 28207
Phone (704) 941-4171

1918 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 384-9437

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

202D McGill Ave NW
Concord, NC 28025
Phone (704) 792-2242

1401 Matthews Township Pkwy
Ste 320
Matthews, NC 28105
Phone (704) 316-9064

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

300 N Salisbury Ave
Spencer, NC 28159
Phone (704) 216-2630

9929 Rea Rd
Ste 101
Waxhaw, NC 28173
Phone (704) 316-1055

175 Kimel Park Dr
Ste 100
Winston Salem, NC 27103
Phone (336) 277-1811

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: rkannali438314@direct.novanthealth.org

Organizations & group practices 10

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1174879415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 RANDOLPH RD STE 800",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071110",
            "telephone_number": "704-384-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNALI",
        "first_name": "RAJASEKHAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-24",
        "last_updated": "2020-10-27",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "126916",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2017-00073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkannali438314@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1900 Randolph Rd Ste 800",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282071110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.