Individual provider Active NPI

Preetam Nallu Reddy, MD

  • Psychiatry Physician
  • North Little Rock, AR
National Provider Identifier
1457812703
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD-24516 Issued in HI
Practice address
3201 Springhill Dr Ste 400
North Little Rock, AR 72117-2910
Phone
(501) 945-8838
Fax
(501) 945-8835
NPI assigned
Mar 28, 2019
Last updated
Jul 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD-24516 HI Primary

Addresses

Primary practice location

3201 Springhill Dr Ste 400
North Little Rock, AR 72117-2910

Mailing address

78-6831 Alii Dr Ste 328
Kailua Kona, HI 96740-4408
Phone (808) 747-8321

Other practice location 1

900 8th Ave
Fort Worth, TX 76104-3902
Phone (817) 347-1140

Other practice location 2

78-6831 Alii Dr Ste 328
Kailua Kona, HI 96740-4408
Phone (808) 747-8321

Other practice location 3

2301 W Michigan Ave
Midland, TX 79701
Phone (432) 620-1160

Other identifiers 1

IdentifierTypeStateIssuer
00124871901MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200807002078 TX Order and Referring Only - PsychiatryPractitioner - Psychiatry 5991120982

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-24516HIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kona Hospital Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1457812703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78-6831 ALII DR STE 328",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967404408",
            "telephone_number": "808-747-8321",
            "fax_number": "808-331-8682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 SPRINGHILL DR STE 400",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172910",
            "telephone_number": "501-945-8838",
            "fax_number": "501-945-8835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761043902",
            "country_code": "US",
            "telephone_number": "817-347-1140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "78-6831 Alii Dr Ste 328",
            "address_purpose": "LOCATION",
            "city": "Kailua Kona",
            "state": "HI",
            "postal_code": "967404408",
            "country_code": "US",
            "telephone_number": "808-747-8321",
            "fax_number": "808-331-8682",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2301 W Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "TX",
            "postal_code": "79701",
            "country_code": "US",
            "telephone_number": "432-620-1160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDY",
        "first_name": "PREETAM",
        "middle_name": "NALLU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-28",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "MD-24516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124871901",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.