Individual provider Active NPI

Anuragh Reddy Gudur, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1588246748
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.170477 Issued in IL
Practice address
259 E Erie St
Chicago, IL 60611-2987
Phone
(312) 695-5620
NPI assigned
Apr 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.170477 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

259 E Erie St
Chicago, IL 60611-2987

Mailing address

259 E Erie St
Chicago, IL 60611-2987
Phone (312) 695-5620

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-0816
Phone (434) 924-1931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20210624000528 VA Order and Referring Only - Internal MedicinePractitioner - GastroenterologyPractitioner - Internal Medicine 3274934583

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.170477ILMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: anuragh.gudur.1@20955.direct.athenahealth.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1588246748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-695-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-695-5620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-1931",
            "fax_number": "434-243-5770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUDUR",
        "first_name": "ANURAGH",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-26",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.170477",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.