Active NPI
Sujatha S Reddy, MD
- Nephrology Physician
- Prestonsburg, KY
National Provider Identifier
1518939883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 22826
- Practice address
- 61 Dewey St
Prestonsburg, KY 41653 - Phone
- (606) 886-3894
- Fax
- (606) 886-6277
- NPI assigned
- Feb 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 22826 | KY | Primary |
Addresses
Primary practice location
61 Dewey St
Prestonsburg, KY 41653
Mailing address
PO Box 640
Prestonsburg, KY 41653
Phone (606) 886-3894
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64228265 | Medicaid | KY |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265673600000",
"number": "1518939883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 640",
"city": "PRESTONSBURG",
"state": "KY",
"postal_code": "41653",
"telephone_number": "606-886-3894",
"fax_number": "606-886-6277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61 DEWEY ST",
"city": "PRESTONSBURG",
"state": "KY",
"postal_code": "41653",
"telephone_number": "606-886-3894",
"fax_number": "606-886-6277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDDY",
"first_name": "SUJATHA",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-02",
"last_updated": "2010-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "KY",
"license": "22826",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64228265",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Prestonsburg, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.