Kavita Pendurthi, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MO100691 Issued in MO

Practice address

600 E 5TH St
Fulton State Hospital
Fulton, MO 65251-1753

Phone

(573) 592-4100

Fax

(573) 592-3023

NPI assigned

Aug 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kavita Yalamanchili Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1235140567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E 5TH ST",
            "address_2": "FULTON STATE HOSPITAL",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652511753",
            "telephone_number": "573-592-4100",
            "fax_number": "573-592-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E 5TH ST",
            "address_2": "FULTON STATE HOSPITAL",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652511753",
            "telephone_number": "573-592-4100",
            "fax_number": "573-592-3023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDURTHI",
        "first_name": "KAVITA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "MO100691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208219501",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAVITA",
            "last_name": "YALAMANCHILI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Michele Patrick, LCSW
• Hunter Lee Patterson, MD, PHD, MBA
• Katherine Diane Payne Cook, LMSW
• Peace of Mind in Care Services LLC
• Dorothy Ann Peery
• Richelle Renee Perkins, ATC
• Andrew Joseph Peterson, MD
• Jessica Peterson, PHD
• Jennifer Petzet
• Phoenix Chiropractic Center

• Psychiatry Physician in Fulton, MO
• Providers in Fulton, MO by specialty
• Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.