NPIMap

Individual provider Active NPI

Krishna Rao Nalluri, M.D.

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Gulfport, MS
National Provider Identifier
1336212554
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
License
12722 Issued in MS
Practice address
10051 Lorraine Rd
Suite B
Gulfport, MS 39503-6001
Phone
(228) 868-5493
Fax
(228) 868-9930
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 12722 MS Primary

Addresses

Primary practice location

10051 Lorraine Rd
Suite B
Gulfport, MS 39503-6001

Mailing address

10051 Lorraine Rd
Suite B
Gulfport, MS 39503-6001
Phone (228) 868-5493

Other identifiers 1

IdentifierTypeStateIssuer
09014923MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040827000646 MS Practitioner - Neurology 1850366469 Reassigns benefits to 1 organization
I20150123000767 FL Practitioner - Neurology 1850366469 Reassigns benefits to 1 organization
Practice locations: Orange Park, FL

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-5201

Hospital & facility affiliations

  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
National Neurodiagnostic Technologies Inc CurrentSince Nov 1, 2014 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Neuroscience Institute of the Gulf Coast PLLC Sleep Medicine PastSince Mar 10, 1999 Accepting new patients

Locations

1895 Kingsley Ave
Ste 1005
Orange Park, FL 32073
Phone (904) 677-7873

4500 13th St
#P
Gulfport, MS 39501
Phone (228) 865-3451

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

Interoperability endpoints

  • Direct secure messaging: knalluri@direct.mhg.com

Organizations & group practices 5

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 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1336212554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051 LORRAINE RD",
            "address_2": "SUITE B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395036001",
            "telephone_number": "228-868-5493",
            "fax_number": "228-868-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10051 LORRAINE RD",
            "address_2": "SUITE B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395036001",
            "telephone_number": "228-868-5493",
            "fax_number": "228-868-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLURI",
        "first_name": "KRISHNA",
        "middle_name": "RAO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "MS",
            "license": "12722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09014923",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.