Mediport Solutions LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MEDIPORT SOLUTIONS LLC

Practice address

7900 NW 23Rd St Ste 2
Bethany, OK 73008-4961

Phone

(978) 230-3851

NPI assigned

Aug 7, 2025

Last updated

Aug 22, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shyam Sundar Reddy Chitturi

Title

Business Owner

Phone

(978) 230-3851

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1754524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755820800000",
    "number": "1447135603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 NW 23RD ST STE 2",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730084961",
            "telephone_number": "978-230-3851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 NW 23RD ST STE 2",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730084961",
            "telephone_number": "978-230-3851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIPORT SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A",
        "authorized_official_last_name": "CHITTURI",
        "authorized_official_first_name": "SHYAM SUNDAR REDDY",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "978-230-3851"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin M McGowen
• Elizabeth Anne McGrew, MA
• Yasmyn McHenry
• Mandy McHugh, MSW
• Tiffani Danae McKenzie, LPC
• Sarah Mary Mende, MD, MPH
• Stephanie Christine Mestre, DPT
• Michael E. Henderson
• Melanie Milbourn, DPT
• Kaitlyn Danae Miller, DPT

• Clinical Medical Laboratory in Bethany, OK
• Providers in Bethany, OK by specialty
• Clinical Medical Laboratory in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; 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.