NPIMap

Individual provider Active NPI

Srinivasa Rao Chintalapudi, MD

  • Internal Medicine Physician
  • Maynardville, TN
National Provider Identifier
1316937774
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30576 Issued in TN
Practice address
149 Durham Dr
Maynardville, TN 37807-2925
Phone
(865) 992-2221
Fax
(833) 908-2158
NPI assigned
Oct 26, 2005
Last updated
Mar 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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 30576 TN Primary

Addresses

Primary practice location

149 Durham Dr
Maynardville, TN 37807-2925

Mailing address

1275 Dick Lonas Rd Unit 101
Knoxville, TN 37909-1383
Phone (865) 584-4747

Other identifiers 1

IdentifierTypeStateIssuer
3728963MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20040715001390 TN Practitioner - Internal Medicine 6901885672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

149 Durham Dr
Maynardville, TN 37807-2925
Phone (865) 992-2221

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions109
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30576TNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Medical Center PC Internal Medicine CurrentSince Oct 1, 2001 Accepting new patients
NPI 1225445141 Internal Medicine CurrentSince Sep 1, 2012 Accepting new patients
Summit Medical Group, PLLC Internal Medicine CurrentSince Sep 1, 2012 Accepting new patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients
Summit Medical Group,PLLC Internal Medicine Past Accepting new patients
Mohammad Bhidya MD PC PastSince Jan 1, 2001 Accepting new patients
Summit Medical Group, PLLC Internal Medicine Past Accepting new patients

Locations

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

1275 Dick Lonas Rd
Unit 101
Knoxville, TN 37909

149 Durham Dr
Maynardville, TN 37807
Phone (865) 992-2221

215 Richardson Way
Maynardville, TN 37807
Phone (423) 992-5816

Organizations & group practices 6

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 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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1316937774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 DICK LONAS RD UNIT 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091383",
            "telephone_number": "865-584-4747",
            "fax_number": "865-584-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 DURHAM DR",
            "city": "MAYNARDVILLE",
            "state": "TN",
            "postal_code": "378072925",
            "telephone_number": "865-992-2221",
            "fax_number": "833-908-2158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINTALAPUDI",
        "first_name": "SRINIVASA",
        "middle_name": "RAO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "30576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3728963",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maynardville, TN

Sources for this page

Verify at the official NPI Registry.