Active NPI
Vamsi Krishna Pachchipulusu, M.D
- Student in an Organized Health Care Education/Training Program
- Fort Walton Beach, FL
National Provider Identifier
1386498699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1000 Mar Walt Dr
HCA Florida Fort Walton Destin Hospital
Fort Walton Beach, FL 32547 - Phone
- (850) 969-4500
- NPI assigned
- Apr 15, 2024
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1000 Mar Walt Dr
HCA Florida Fort Walton Destin Hospital
Fort Walton Beach, FL 32547
Mailing address
1000 Mar Walt Dr
HCA Florida Fort Walton Destin Hospital
Fort Walton Beach, FL 32547
Phone (850) 969-4500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240906003339 | FL | Order and Referring Only - Internal Medicine | 8628518404 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- vamsi.krishna.pachchipulusu.1@21123.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721174400000",
"number": "1386498699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 MAR WALT DR",
"address_2": "HCA FLORIDA FORT WALTON DESTIN HOSPITAL",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "32547",
"telephone_number": "850-969-4500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 MAR WALT DR",
"address_2": "HCA FLORIDA FORT WALTON DESTIN HOSPITAL",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "32547",
"telephone_number": "850-969-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACHCHIPULUSU",
"first_name": "VAMSI KRISHNA",
"name_prefix": "Mr.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-04-15",
"last_updated": "2024-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.