Individual provider Active NPI

Krishna Vellanki

  • Psychiatry Physician
  • Greer, SC
National Provider Identifier
1376283424
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
34.017674 Issued in OH
Practice address
109 Physicians Dr
Greer, SC 29650-2446
Phone
(864) 455-5777
NPI assigned
Mar 29, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 34.017674 OH Primary
Psychiatry Physician 2084P0800X 87525 SC

Addresses

Primary practice location

109 Physicians Dr
Greer, SC 29650-2446

Mailing address

1241 McKinley Ave
Columbus, OH 43222-1114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LL87525SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Executive Psychiatry, LLC Psychiatry Current Accepting new patients

Locations

1241 McKinley Ave
Columbus, OH 43222

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": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1376283424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 MCKINLEY AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PHYSICIANS DR",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296502446",
            "telephone_number": "864-455-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELLANKI",
        "first_name": "KRISHNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-29",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "34.017674",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "87525",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.