Mallepalli MD a Professional

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

License

12443R Issued in LA

Legal business name

MALLEPALLI MD A PROFESSIONAL

Practice address

2408 Duval Dr Ste 2
Monroe, LA 71201-2986

Phone

(318) 388-8561

Fax

(318) 388-8564

NPI assigned

Mar 19, 2007

Last updated

Jun 26, 2019By 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

Dr. Venkat N. MallepalliNPI 1265546527

Title

President

Phone

(318) 388-8561

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Venkat N. Mallepalli, M.D.

  • Internal Medicine Physician
  • Monroe, LA
  • NPI 1265546527
  Medicare reassignment NPD Authorized official
• Jyothi Reddy Mallepalli, MD

  • Rheumatology Physician
  • Monroe, LA
  • NPI 1184635344
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561507200000",
    "number": "1447374921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 DUVAL DR STE 2",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712012986",
            "telephone_number": "318-388-8561",
            "fax_number": "318-388-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 DUVAL DR STE 2",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712012986",
            "telephone_number": "318-388-8561",
            "fax_number": "318-388-8564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1602 Royal Ave",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "712015612",
            "country_code": "US",
            "telephone_number": "318-388-8561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MALLEPALLI MD A PROFESSIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2019-06-26",
        "status": "A",
        "authorized_official_last_name": "MALLEPALLI",
        "authorized_official_first_name": "VENKAT",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-388-8561",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "LA",
            "license": "12443R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1536199",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamara Maine
• La'Nantra Louise Major
• Tina Major
• Stacey Gordon Majure, DPT
• Jason Andrew Maljaars, MD
• Jyothi Reddy Mallepalli, MD
• Venkat N. Mallepalli, M.D.
• Caitlyn Elizabeth Malloy Nims, FNP-C
• Audrey Malloy, MA CCC-SLP
• Kim Ramon Malmay, M.D.

• Community Health Clinic/Center in Monroe, LA
• Providers in Monroe, LA by specialty
• Community Health Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.