Active NPI
Raju Manga Vanapalli, MD
- Orthopaedic Surgery Physician
- Morrow, GA
National Provider Identifier
1255398962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 22656
- Practice address
- 1115 Mount Zion Rd
Suite J
Morrow, GA 30260-2266 - Phone
- (770) 968-7421
- Fax
- (770) 960-0078
- NPI assigned
- Apr 27, 2006
- 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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 22656 | GA | Primary |
Addresses
Primary practice location
1115 Mount Zion Rd
Suite J
Morrow, GA 30260-2266
Mailing address
1115 Mount Zion Rd
Suite J
Morrow, GA 30260-2266
Phone (770) 968-7421
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22656 | GA | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Resurgens, LLC | Orthopaedic Surgery | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191974400000",
"number": "1255398962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 MOUNT ZION RD",
"address_2": "SUITE J",
"city": "MORROW",
"state": "GA",
"postal_code": "302602266",
"telephone_number": "770-968-7421",
"fax_number": "770-960-0078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 MOUNT ZION RD",
"address_2": "SUITE J",
"city": "MORROW",
"state": "GA",
"postal_code": "302602266",
"telephone_number": "770-968-7421",
"fax_number": "770-960-0078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANAPALLI",
"first_name": "RAJU",
"middle_name": "MANGA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-27",
"last_updated": "2007-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "GA",
"license": "22656",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morrow, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.