Individual provider Active NPI

Neetha Vadde, MD

  • Internal Medicine Physician
  • Montgomery, AL
National Provider Identifier
1467988295
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
41237 Issued in AL
Practice address
2105 E South Blvd
Montgomery, AL 36116-2409
Phone
(334) 286-3585
Fax
(334) 286-3539
NPI assigned
May 11, 2017
Last updated
Sep 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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 41237 AL Primary

Addresses

Primary practice location

2105 E South Blvd
Montgomery, AL 36116-2409

Mailing address

2105 E South Blvd
Montgomery, AL 36116-2409
Phone (334) 286-3585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20201208003179 AL Practitioner - Internal Medicine 8921410325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

124 S Memorial Dr
Prattville, AL 36067-3619
Phone (334) 365-0551

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41237ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Sep 1, 2020 Accepting new patients

Locations

2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842

124 S Memorial Dr
Prattville, AL 36067
Phone (334) 361-4267

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.

Hospital & facility affiliations 1

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1467988295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 E SOUTH BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162409",
            "telephone_number": "334-286-3585",
            "fax_number": "334-286-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 E SOUTH BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162409",
            "telephone_number": "334-286-3585",
            "fax_number": "334-286-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADDE",
        "first_name": "NEETHA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "41237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.