Surya Nallamala

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT5668 Issued in MS

Practice address

1670 Whitehouse Rd
Iuka, MS 38852-9013

Phone

(601) 605-6777

NPI assigned

Aug 12, 2020

Last updated

Aug 12, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fyzio Group LLCGroup PAC ID 0840666830, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fyzio Group LLC

  dba FYZICAL Therapy & Balance Centers

  • Physical Therapist
  • McKinney, TX
  • NPI 1609595883
  Medicare reassignment Care Compare group NPD
• Burke PT Group LLC

  • Physical Therapist
  • Frisco, TX
  • NPI 1871240143
  NPD
• Huffman Rehab PLLC

  dba Joints In Motion Physical Therapy - Prosper

  • Physical Therapist
  • Celina, TX
  • NPI 1992006324
  NPD (past)

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1407467582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 AVIGNON DR",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575120",
            "telephone_number": "601-605-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 WHITEHOUSE RD",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388529013",
            "telephone_number": "601-605-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLAMALA",
        "first_name": "SURYA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT5668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jana Moore, R.N.
• Janet Morton, RN
• Laycie Mott, LPC
• Murray Medical Alliance LLC (Iuka Family Clinic)
• Bradley Alton Murray, MD
• Xavier Neal, MS
• North Mississippi Medical Clinics Inc (Iuka Medical Clinic)
• North Mississippi Medical Clinics, Inc.
• Kenneth Evan Nunley, M.ED
• Katie Oaks, OT

• Physical Therapist in Iuka, MS
• Providers in Iuka, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.