Active NPI
Sathyanarayana Naidu Koidala Veera Venkata
- Physical Therapist
- Gastonia, NC
National Provider Identifier
1508496555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P16793
- Practice address
- 2675 Court Dr
Gastonia, NC 28054-1478 - Phone
- (704) 824-7800
- NPI assigned
- Jan 17, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P16793 | NC | Primary |
Addresses
Primary practice location
2675 Court Dr
Gastonia, NC 28054-1478
Mailing address
8718 Upland Dr Apt 201
Charlotte, NC 28216-4883
Phone (702) 278-2394
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P16793 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579219200000",
"number": "1508496555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8718 UPLAND DR APT 201",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282164883",
"telephone_number": "702-278-2394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2675 COURT DR",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280541478",
"telephone_number": "704-824-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOIDALA VEERA VENKATA",
"first_name": "SATHYANARAYANA NAIDU",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-01-17",
"last_updated": "2020-01-17",
"certification_date": "2020-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P16793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.