Suvarna Kolluri, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

Q0088 Issued in TX

Practice address

9509 N Beach St Ste 102
Fort Worth, TX 76244-6399

Phone

(817) 617-8600

NPI assigned

Jul 6, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: skolluri105256@direct.phhs.org

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.

• Dallas County Hospital District

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1649278995
  Medicare reassignment
• Dallas County Hospital District

  • Federally Qualified Health Center (FQHC)
  • Dallas, TX
  • NPI 1356852784

  Family Medicine

  NPD
• Dallas County Hospital District

  • Women's Health Nurse Practitioner
  • Dallas, TX
  • NPI 1558035188
  NPD
• Dallas County Hospital District

  • Women's Health Nurse Practitioner
  • Dallas, TX
  • NPI 1831198506
  NPD

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1275898280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 GLEN ABBEY DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921314",
            "telephone_number": "908-249-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9509 N BEACH ST STE 102",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446399",
            "telephone_number": "817-617-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLURI",
        "first_name": "SUVARNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-06",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q0088",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "46281",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica A Koiner, IBCLC
• Shilpa Kolachina, MD
• Jaime Leigh Kolahi, COA
• Donna Cox Kolar, M.D.
• Gabriela Kolberg
• Andrew Ryan Kolodziej
• Jill Kolstad, M.ED
• Daphne Kolstoe, M.S
• Amber Nicole Komorian
• Scharles Alicia Konadu, M.D.

• Pediatrics Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.