Active NPI
Kurapati Bhaskar Reddy, MD, DPM
- Geriatric Psychiatry Physician
- Neillsville, WI
National Provider Identifier
1366467714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Psychiatry Physician
- License
- 1166
- Practice address
- 517 Court St RM 503
Neillsville, WI 54456-1976 - Phone
- (715) 743-5192
- Fax
- (715) 743-5209
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Psychiatry Physician | 2084P0805X | 1166 | WI | Primary |
Addresses
Primary practice location
517 Court St RM 503
Neillsville, WI 54456-1976
Mailing address
402 Southwood CT
Eau Claire, WI 54701-5900
Phone (715) 834-2751
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30565600 | Medicaid | WI |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1166 | WI | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Dunn | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Menomonie, WI
- NPI 1588667406
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366467714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 SOUTHWOOD CT",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547015900",
"telephone_number": "715-834-2751",
"fax_number": "715-743-5209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "517 COURT ST RM 503",
"city": "NEILLSVILLE",
"state": "WI",
"postal_code": "544561976",
"telephone_number": "715-743-5192",
"fax_number": "715-743-5209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDDY",
"first_name": "KURAPATI",
"middle_name": "BHASKAR",
"name_prefix": "Dr.",
"credential": "MD, DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "WI",
"license": "1166",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30565600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Neillsville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.