Individual provider Active NPI

Kalyana CR Pallerla, MD

  • Hospitalist Physician
  • Bowling Green, KY
National Provider Identifier
1275854143
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
TP792 Issued in KY
Practice address
250 Park St
Bowling Green, KY 42101-1760
Phone
(270) 796-6540
Fax
(270) 796-6576
NPI assigned
Jun 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X TP792 KY Primary
Internal Medicine Physician 207R00000X TP792 KY

Addresses

Primary practice location

250 Park St
Bowling Green, KY 42101-1760

Mailing address

PO Box 2697
Bowling Green, KY 42102-7697
Phone (270) 796-6540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110716000010 KY Practitioner - Internal Medicine 5294903332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1100 Brookhaven Rd
Franklin, KY 42134-2746

250 Park St
Bowling Green, KY 42101-1760
Phone (270) 781-7178

456 Burnley Rd
Scottsville, KY 42164-6355
Phone (270) 780-2760

466 Burnley Rd
Scottsville, KY 42164-6355
Phone (270) 780-2750

825 2ND Ave E
Suite C2
Bowling Green, KY 42101-1786

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TP792KYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Health Corporation, Inc. Hospitalist CurrentSince Jul 1, 2011 Accepting new patients
Commonwealth Health Corporation, Inc Current Accepting new patients
Commonwealth Health Corporation, Inc. CurrentSince Jul 1, 2011 Accepting new patients
Bowling Green-Warren County Community Hospital Corporation Past Accepting new patients

Locations

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1275854143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2697",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421027697",
            "telephone_number": "270-796-6540",
            "fax_number": "270-796-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011760",
            "telephone_number": "270-796-6540",
            "fax_number": "270-796-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLERLA",
        "first_name": "KALYANA",
        "middle_name": "CR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-15",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "TP792",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "TP792",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.