Individual provider Active NPI

Kurapati Bhaskar Reddy, MD, DPM

  • Geriatric Psychiatry Physician
  • Neillsville, WI
National Provider Identifier
1366467714
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
1166 Issued in WI
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
30565600MedicaidWI

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. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1166WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.