Active NPI
Bala Krishna V Arabolu, M.D.
- Pediatrics Physician
- Durant, OK
National Provider Identifier
1245237312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 11709
- Practice address
- 1202 N 16TH Ave
Durant, OK 74701-2122 - Phone
- (580) 924-1144
- Fax
- (580) 924-6667
- NPI assigned
- Jul 5, 2005
- Last updated
- Jul 18, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 11709 | OK | Primary |
Addresses
Primary practice location
1202 N 16TH Ave
Durant, OK 74701-2122
Mailing address
1202 N 16TH Ave
Durant, OK 74701-2122
Phone (580) 924-1144
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0741308-01 | Medicaid | TX | |
| 100019390C | Medicaid | OK | |
| 100019390A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11709 | OK | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bala Krishna V Arabolu | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216339200000",
"number": "1245237312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1202 N 16TH AVE",
"city": "DURANT",
"state": "OK",
"postal_code": "747012122",
"telephone_number": "580-924-1144",
"fax_number": "580-924-6667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1202 N 16TH AVE",
"city": "DURANT",
"state": "OK",
"postal_code": "747012122",
"telephone_number": "580-924-1144",
"fax_number": "580-924-6667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARABOLU",
"first_name": "BALA KRISHNA",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-05",
"last_updated": "2008-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OK",
"license": "11709",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0741308-01",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100019390C",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100019390A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durant, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.