Individual provider Active NPI

Vijaya Sripathy, MD

  • General Practice Physician
  • Carlyle, IL
National Provider Identifier
1508925652
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
01040974A Issued in IN
Practice address
18209 Eula Mae Pkwy
Carlyle, IL 62231-6407
Phone
(812) 238-3800
NPI assigned
Dec 6, 2006
Last updated
Jul 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 01040974A IN Primary

Addresses

Primary practice location

18209 Eula Mae Pkwy
Carlyle, IL 62231-6407

Mailing address

18209 Eula Mae Pkwy
Carlyle, IL 62231-6407
Phone (812) 238-3800

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01040974AINMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Medical Inc 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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1508925652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18209 EULA MAE PKWY",
            "city": "CARLYLE",
            "state": "IL",
            "postal_code": "622316407",
            "telephone_number": "812-238-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18209 EULA MAE PKWY",
            "city": "CARLYLE",
            "state": "IL",
            "postal_code": "622316407",
            "telephone_number": "812-238-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIPATHY",
        "first_name": "VIJAYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01040974A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlyle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.