Active NPI
Darshan Subbarao Naidu Thota, M.D.
- Emergency Medicine Physician
- Fort Sam Houston, TX
National Provider Identifier
1447410220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 110703
- Practice address
- 3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504 - Phone
- (210) 916-7500
- NPI assigned
- Jun 14, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 63228 | GA | |
| Clinical Informatics Physician | 2083C0008X | 63228 | GA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 110703 | CA | Primary |
Addresses
Primary practice location
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Mailing address
102 Colony PL
Saint Simons Island, GA 31522-1103
Phone (912) 571-2842
Other practice location 1
9040A Jackson Ave
Joint Base Lewis McChord, WA 98431-1098
Phone (253) 968-1110
Other practice location 2
7700 Arlington Blvd
Falls Church, VA 22042-2929
Phone (912) 571-2842
Other practice location 3
34800 Bob Wilson Dr
Nmcsd
San Diego, CA 92134-1098
Phone (912) 571-2842
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220813000199 | CA | Order and Referring Only - Emergency Medicine | 4385027028 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63228 | GA | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781827200000",
"number": "1447410220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 COLONY PL",
"city": "SAINT SIMONS ISLAND",
"state": "GA",
"postal_code": "315221103",
"telephone_number": "912-571-2842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "210-916-7500"
}
],
"practiceLocations": [
{
"address_1": "9040A Jackson Ave",
"address_purpose": "LOCATION",
"city": "Joint Base Lewis McChord",
"state": "WA",
"postal_code": "984311098",
"country_code": "US",
"telephone_number": "253-968-1110",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7700 Arlington Blvd",
"address_purpose": "LOCATION",
"city": "Falls Church",
"state": "VA",
"postal_code": "220422929",
"country_code": "US",
"telephone_number": "912-571-2842",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "34800 Bob Wilson Dr",
"address_2": "NMCSD",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921341098",
"country_code": "US",
"telephone_number": "912-571-2842",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOTA",
"first_name": "DARSHAN",
"middle_name": "SUBBARAO NAIDU",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-14",
"last_updated": "2026-06-19",
"certification_date": "2026-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "GA",
"license": "63228",
"primary": false
},
{
"code": "2083C0008X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Clinical Informatics",
"state": "GA",
"license": "63228",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "110703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Sam Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.