NPIMap

Individual provider Active NPI

Sreedevi Nonesupplied Guttikonda, MBBS

  • Endocrinology, Diabetes & Metabolism Physician
  • Mesquite, TX
National Provider Identifier
1407050073
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
N7544 Issued in TX
Practice address
1621 N Belt Line Rd Ste a
Mesquite, TX 75149-1795
Phone
(972) 682-5700
Fax
(972) 682-5703
NPI assigned
Jun 14, 2007
Last updated
Jul 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP1-0026433 TX
Endocrinology, Diabetes & Metabolism Physician 207RE0101X N7544 TX Primary

Addresses

Primary practice location

1621 N Belt Line Rd Ste a
Mesquite, TX 75149-1795

Mailing address

1621 N Belt Line Rd Ste a
Mesquite, TX 75149-1795
Phone (972) 682-5700

Other identifiers 1

IdentifierTypeStateIssuer
3857039172OtherMYUTMB 3857039172-COMMERCIAL NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111017000707 TX Practitioner - Endocrinology 2264604230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Endocrinology AssociatesGroup PAC ID 9638271711, 7 clinicians

Practice addresses (Care Compare)

1621 N Belt Line Rd a
Mesquite, TX 75149-1795

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP1-0026433TXMDInternal Medicine Physician

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1407050073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 N BELT LINE RD STE A",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751491795",
            "telephone_number": "972-682-5700",
            "fax_number": "972-682-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 N BELT LINE RD STE A",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751491795",
            "telephone_number": "972-682-5700",
            "fax_number": "972-682-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTTIKONDA",
        "first_name": "SREEDEVI",
        "middle_name": "NONESUPPLIED",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP1-0026433",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "N7544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MYUTMB 3857039172-COMMERCIAL NUMBER",
            "identifier": "3857039172",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.