Anupama Vallala, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036112205 Issued in IL

Practice address

2 Terminal Dr
Suite 8
East Alton, IL 62024-2201

Phone

(618) 259-1419

Fax

(618) 259-1502

NPI assigned

Jun 10, 2006

Last updated

Aug 4, 2014By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: anupama.vallala.1@9559.direct.athenahealth.com

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.

• Southern Illinois Healthcare Foundation Inc

  dba Centreville Health Center

  • Federally Qualified Health Center (FQHC)
  • Centreville, IL
  • NPI 1609813500

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1427099159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 TERMINAL DR",
            "address_2": "SUITE 8",
            "city": "EAST ALTON",
            "state": "IL",
            "postal_code": "620242201",
            "telephone_number": "618-259-1419",
            "fax_number": "618-259-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TERMINAL DR",
            "address_2": "SUITE 8",
            "city": "EAST ALTON",
            "state": "IL",
            "postal_code": "620242201",
            "telephone_number": "618-259-1419",
            "fax_number": "618-259-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLALA",
        "first_name": "ANUPAMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036112205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather L Strebel, M.S. CCC-SLP
• Christopher Dean Suhre, MD
• Sathien Suntra, M.D., FACS
• TGW Management PLLC
• Soontorn Thrupkaew, MD
• Danny Joe Vetter, D.C.
• Joni Marie Whitfield, OTR/L
• Gregory L Wigton, D.D.S.
• Megan Williams, LMT
• Nathan G Wilson, LPT

• Pediatrics Physician in East Alton, IL
• Providers in East Alton, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.