Individual provider Active NPI

Vignesh Sadras Balagopal, MD

  • Psychiatry Physician
  • Fayetteville, NC
National Provider Identifier
1366089120
Registry record updated Jan 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD600001722 Issued in DC
Practice address
1638 Owen Dr
Fayetteville, NC 28304-3424
Phone
(910) 615-3333
NPI assigned
Nov 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD600001722 DC Primary

Addresses

Primary practice location

1638 Owen Dr
Fayetteville, NC 28304-3424

Mailing address

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20250825002510 NC Order and Referring Only - PsychiatryPractitioner - Psychiatry 0244730133

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD600001722DCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Faculty Associates, Inc PastSince Jul 1, 2022 Accepting new patients
Foggy Bottom Physician Group Inc. PastSince Jul 1, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: vsadras41948@gwmfa.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1574899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768608000000",
    "number": "1366089120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALAGOPAL",
        "first_name": "VIGNESH",
        "middle_name": "SADRAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-28",
        "last_updated": "2026-01-17",
        "certification_date": "2026-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DC",
            "license": "MD600001722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.