Kalyana C. R. Boddapati, M.D

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

2012-00019 Issued in NC

Practice address

1705 Tarboro St SW
Wilson, NC 27893-3428

Phone

(252) 399-8040

NPI assigned

Jan 14, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC, VA, NC3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

HospitalistAlso: Internal Medicine

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Apogee Medical Group North CarolinaGroup PAC ID 7719162254, 78 clinicians

North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rex Hospital Hospital, Raleigh, NC, CCN 340114
• Wilson Medical Center Hospital, Wilson, NC, CCN 340126

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kboddapati605107@direct.unc.nchie.net

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.

• North Carolina MG, LLC

  dba UNC Health North Carolina Heart and Vascular

  • Hospitalist Physician
  • Raleigh, NC
  • NPI 1215741640
  Medicare reassignment Care Compare group NPD
• Apogee Medical Group North Carolina

  • Hospitalist Physician
  • Scottsdale, AZ
  • NPI 1043518228

  NC

  Medicare reassignment Care Compare group NPD
• Apogee Medical Group South Carolina

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1619028545

  SC

  Medicare reassignment NPD
• Apogee Medical Group Virginia, PC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1861660540

  VA

  Medicare reassignment NPD
• Granville Health System

  dba Granville CRNA Group

  • Certified Registered Nurse Anesthetist
  • Oxford, NC
  • NPI 1275638512
  Medicare reassignment
• Rex Hospital Inc

  dba North Carolina Heart and Vascular

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1972939643
  NPD (past)

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

• DLP Wilson Medical Center LLC

  dba Wilson Medical Center

  • General Acute Care Hospital
  • Wilson, NC
  • NPI 1215359922
  Care Compare affiliation
• DLP Wilson Medical Center LLC

  dba Wilson Medical Center

  • Psychiatric Hospital Unit
  • Wilson, NC
  • NPI 1386196459
  Care Compare affiliation
• Rex Hospital Inc.

  dba Rex Hospital

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1497797088
  Care Compare affiliation

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1407186422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 708760",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840708760",
            "telephone_number": "801-352-9500",
            "fax_number": "801-352-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 TARBORO ST SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933428",
            "telephone_number": "252-399-8040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4420 Lake Boone Trl",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276077505",
            "country_code": "US",
            "telephone_number": "919-784-7093",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1304 W Bobo Newsom Hwy",
            "address_purpose": "LOCATION",
            "city": "Hartsville",
            "state": "SC",
            "postal_code": "295504710",
            "country_code": "US",
            "telephone_number": "843-339-4883",
            "fax_number": "843-339-4102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODDAPATI",
        "first_name": "KALYANA C. R.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-14",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2012-00019",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301089020",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2012-00019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kboddapati605107@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4420 Lake Boone Trl",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276077505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Blake
• Ashley Johnson Blalock
• Deborah Blalock
• Nikolas Bland
• Blooming Beginnings PLLC
• Body Whole Health and Counseling
• Boles and Ham DDS PA
• William B Boles III, DDS
• William B Boles Jr., DDS
• Bolton Enterprises I PLLC (First Choice Chiropractic Clinic)

• Hospitalist Physician in Wilson, NC
• Providers in Wilson, NC by specialty
• Hospitalist Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.