Individual provider Active NPI

Chelukala Bapu Reddy, M.D.

  • Internal Medicine Physician
  • Griffin, GA
National Provider Identifier
1467549840
Registry record updated Dec 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
27431 Issued in GA
Practice address
610 S 8TH St
Suite C
Griffin, GA 30224-4201
Phone
(770) 228-9719
Fax
(770) 228-8244
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 27431 GA Primary

Addresses

Primary practice location

610 S 8TH St
Suite C
Griffin, GA 30224-4201

Mailing address

610 S 8TH St
Suite C
Griffin, GA 30224-4201
Phone (770) 228-9719

Other identifiers 1

IdentifierTypeStateIssuer
00325102AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20120425000423 GA Practitioner - Internal Medicine 5698937399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

610 S 8TH St
Griffin, GA 30224-4201
Phone (770) 228-9719

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Columbus, GA, CCN 117306
  • Wellstar Spalding Medical Center Hospital, Griffin, GA, CCN 110031

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27431GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pruitthealth - Griffin, LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386201600000",
    "number": "1467549840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S 8TH ST",
            "address_2": "SUITE C",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244201",
            "telephone_number": "770-228-9719",
            "fax_number": "770-228-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S 8TH ST",
            "address_2": "SUITE C",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244201",
            "telephone_number": "770-228-9719",
            "fax_number": "770-228-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "CHELUKALA",
        "middle_name": "BAPU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2013-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "27431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00325102A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

Verify at the official NPI Registry.