Individual provider Active NPI

Sarojini Devi Naidu, M.D.

  • Family Medicine Physician
  • Waterloo, IA
National Provider Identifier
1295082170
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R9541 Issued in IA
Practice address
2055 Kimball Ave
Suite 101
Waterloo, IA 50702-5047
Phone
(319) 272-2112
Fax
(319) 272-2107
NPI assigned
Aug 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R9541 IA Primary

Addresses

Primary practice location

2055 Kimball Ave
Suite 101
Waterloo, IA 50702-5047

Mailing address

2055 Kimball Ave
Suite 101
Waterloo, IA 50702-5047
Phone (319) 272-2112

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

LicenseStateTypeSpecialty
R9541IAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1295082170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 KIMBALL AVE",
            "address_2": "SUITE 101",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025047",
            "telephone_number": "319-272-2112",
            "fax_number": "319-272-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 KIMBALL AVE",
            "address_2": "SUITE 101",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025047",
            "telephone_number": "319-272-2112",
            "fax_number": "319-272-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIDU",
        "first_name": "SAROJINI",
        "middle_name": "DEVI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R9541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.