Vijaya Sripathy, MD
Individual provider Active NPI General Practice Physician · Carlyle, IL
NPI 1508925652 · NPPES record last updated Jul 17, 2013
Key facts
- NPI
- 1508925652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 01040974A (IN)
- Practice address
- 18209 Eula Mae Pkwy
Carlyle, IL 62231-6407 - Phone
- (812) 238-3800
- NPI assigned
- Dec 6, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Choice Medical Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 01040974A | IN | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100360220 | Medicaid | IN |
Other providers in Carlyle, IL
- Jeffrey A Schatz
- Brandy J Scheer
- Lori Kay Schniers
- Jamie Marie Seiffert
- Holly Renee Shoesmith
- St Josephs Hospital Breese of the Hospital Sisters of the Third Orde
- St Josephs Hospital Breese of the Hospital Sisters of the Third Orde
- Bridgett M Stark
- Windy Lee Stone
- The Residential Developers, Inc.
All providers in Carlyle, IL · General Practice Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.