NPIMap

Individual provider Active NPI

Mythri Mudireddy, MD

  • Internal Medicine Physician
  • Cleveland, OH
National Provider Identifier
1295223196
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
57.245880 Issued in OH
Practice address
2351 E 22ND St
Cleveland, OH 44115-3111
Phone
(216) 861-6200
Fax
(216) 363-7490
NPI assigned
Apr 25, 2018
Last updated
Apr 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57.245880 OH Primary

Addresses

Primary practice location

2351 E 22ND St
Cleveland, OH 44115-3111

Mailing address

2351 E 22ND St
Cleveland, OH 44115-3111
Phone (216) 861-6200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240723000083 MS Practitioner - Internal Medicine 0648716084 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clay County Medical CorporationGroup PAC ID 4789649609, 36 clinicians

Practice addresses (Care Compare)

1205 Hwy 182 W
Clay County Medical Corporation
Starkville, MS 39759-9820
Phone (662) 320-8545

961 S Gloster St
North Mississippi Medical Center Hematology
Tupelo, MS 38801-6343
Phone (662) 377-4550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.245880OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clay County Medical Corporation CurrentSince Jul 11, 2024 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Clay County Medical Corporation Current Accepting new patients
Clay County Medical Corporation CurrentSince Jul 11, 2024 Accepting new patients
Clay County Medical Corporation Current Accepting new patients
North Mississippi Medical Center Inc CurrentSince Jul 11, 2024 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Jul 11, 2024 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
Clay County Medical Corporation Past Accepting new patients
Amory Surgery Clinic, PLLC Past Accepting new patients

Locations

1205 Highway 182 W
Starkville, MS 39759
Phone (662) 320-8545

808 Varsity Dr
Tupelo, MS 38801
Phone (662) 377-2386

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

961 S Gloster St
Tupelo, MS 38801
Phone (601) 844-9166

150 Medical Center Dr
West Point, MS 39773
Phone (601) 494-2321

Interoperability endpoints

  • Direct secure messaging: mythrimudireddy@nmhs.medalliesdirect.net

Organizations & group practices 10

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.

Hospital & facility affiliations 5

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": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1295223196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 E 22ND ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153111",
            "telephone_number": "216-861-6200",
            "fax_number": "216-363-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 E 22ND ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153111",
            "telephone_number": "216-861-6200",
            "fax_number": "216-363-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDIREDDY",
        "first_name": "MYTHRI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-25",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.245880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.