Organization Active NPI

HL Krupadev MD LLC

  • Internal Medicine Physician
  • Marietta, OH
National Provider Identifier
1215054200
Registry record updated Apr 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35042059K Issued in OH
Legal business name
HL KRUPADEV MD LLC
Practice address
408 Third Street
Marietta, OH 45750
Phone
(740) 373-5119
NPI assigned
Mar 23, 2007
Last updated
Apr 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2011

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

Authorized official

Name
Pamela L Kehl
Title
Office Manager
Phone
(740) 373-5119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35042059K OH Primary

Addresses

Primary practice location

408 Third Street
Marietta, OH 45750

Mailing address

408 Third Street
Marietta, OH 45750
Phone (740) 373-5119

Other identifiers 1

IdentifierTypeStateIssuer
0445923MedicaidOH

Other names 1

  • HL Krupadev MD Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060424000352 OH Part B Supplier - Clinic/Group Practice 9931119716 Receives reassigned benefits from 1 practitioner
Practice locations: Marietta, OH

National Provider Directory

National Provider Directory

Locations

408 3rd St
Marietta, OH 45750
Phone (614) 373-5119

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303862400000",
    "number": "1215054200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 THIRD STREET",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "45750",
            "telephone_number": "740-373-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 THIRD STREET",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "45750",
            "telephone_number": "740-373-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HL KRUPADEV MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2011-04-27",
        "status": "A",
        "authorized_official_last_name": "KEHL",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "740-373-5119"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35042059K",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445923",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HL Krupadev MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marietta, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.