Active NPI
Lakshmi Isanaka Chillakuru, M.D
- Family Medicine Physician
- Crownsville, MD
National Provider Identifier
1184810905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- D67361
- Practice address
- 1454 Fairfield Loop Rd
Crownsville, MD 21032-2006 - Phone
- (410) 987-6338
- NPI assigned
- Sep 16, 2007
- Last updated
- Dec 1, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | D67361 | MD | Primary |
Addresses
Primary practice location
1454 Fairfield Loop Rd
Crownsville, MD 21032-2006
Mailing address
PO Box 778
Easton, MD 21601-8914
Phone (410) 763-8787
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 16 Fusting Opco LLC | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Parkway Medical Association LLC | Past | Accepting new patients | |
| Gold Shield Medical Services LLC | Family Medicine | Past | Accepting new patients |
Organizations & group practices 5
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.
-
dba Autumn Lake Healthcare at Catonsville
- Skilled Nursing Facility
- Catonsville, MD
- NPI 1194301960
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Internal Medicine Physician
- Glen Burnie, MD
- NPI 1881201184
Family Medicine
-
- Psychiatric/Mental Health Nurse Practitioner
- Glen Burnie, MD
- NPI 1831846070
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669852800000",
"number": "1184810905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 778",
"city": "EASTON",
"state": "MD",
"postal_code": "216018914",
"telephone_number": "410-763-8787",
"fax_number": "443-496-3443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1454 FAIRFIELD LOOP RD",
"city": "CROWNSVILLE",
"state": "MD",
"postal_code": "210322006",
"telephone_number": "410-987-6338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILLAKURU",
"first_name": "LAKSHMI",
"middle_name": "ISANAKA",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-16",
"last_updated": "2022-12-01",
"certification_date": "2022-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "D67361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crownsville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.