NPIMap

Individual provider Active NPI

Nanni Pidikiti, M.D.

  • Cardiovascular Disease Physician
  • Corinth, MS
National Provider Identifier
1417970518
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
13497 Issued in MS
Practice address
703 Alcorn Dr
Suite 104
Corinth, MS 38834-9302
Phone
(662) 286-9393
Fax
(662) 286-9533
NPI assigned
Jul 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 13497 MS Primary

Addresses

Primary practice location

703 Alcorn Dr
Suite 104
Corinth, MS 38834-9302

Mailing address

703 Alcorn Dr
Suite 104
Corinth, MS 38834-9302
Phone (662) 286-9393

Other identifiers 1

IdentifierTypeStateIssuer
00113432MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20070413000047 MS Practitioner - Cardiovascular Disease (Cardiology) 4789789181 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magnolia Regional Health CenterGroup PAC ID 9739078460, 15 clinicians

Practice addresses (Care Compare)

611 Alcorn Dr
Corinth, MS 38834-9321
Phone (662) 293-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair49
Leg revascularization (restoring blood flow)13
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Regional Health Center CurrentSince Dec 1, 1995 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center Cardiovascular Disease CurrentSince Dec 1, 1995 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Nanni Pidikiti MD PC Cardiovascular Disease CurrentSince Apr 15, 1994 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia General and Vascular Surgery Clinic CurrentSince Feb 29, 2020 Accepting new patients
Magnolia Women's Center Past Accepting new patients

Locations

611 Alcorn Dr
Corinth, MS 38834
Phone (601) 286-6961

611 Alcorn Dr
Ste 210
Corinth, MS 38834
Phone (662) 284-9910

703 Alcorn Dr
Ste 104
Corinth, MS 38834
Phone (662) 286-9393

Organizations & group practices 10

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 6

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417970518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 ALCORN DR",
            "address_2": "SUITE 104",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349302",
            "telephone_number": "662-286-9393",
            "fax_number": "662-286-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 ALCORN DR",
            "address_2": "SUITE 104",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349302",
            "telephone_number": "662-286-9393",
            "fax_number": "662-286-9533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIDIKITI",
        "first_name": "NANNI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "13497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00113432",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

Verify at the official NPI Registry.