Champakamala Honganur Rajanna, M.D.,

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

053738 Issued in CT

Practice address

189 Storrs Rd
Mansfield Center, CT 06250-1683

Phone

(646) 685-6671

NPI assigned

Aug 14, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Psychiatry

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Natchaug Hospital, IncGroup PAC ID 5395648737, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: champakamala.rajanna@xdr.hhchealthdirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Natchaug Hospital, Inc.

  • Psychiatric Hospital
  • Mansfield Center, CT
  • NPI 1295811321
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1313280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1598044133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 STORRS RD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501683",
            "telephone_number": "646-685-6671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 STORRS RD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501683",
            "telephone_number": "646-685-6671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJANNA",
        "first_name": "CHAMPAKAMALA",
        "middle_name": "HONGANUR",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-14",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116024030",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "053738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne M Powell, MD
• Candace F Powers, LCSW
• Allison Price, LMFT
• Professional Resource Group PC
• Chad Edward Quensen, MFT
• Ralph J. Laguardia, M.D, P.C.
• Jonathan Matthew Raub, M.D., M.P.H., M.A.
• Jasmain Reese
• Amanda Avery Risley, LPC
• Phoebe Ritrovato, LMSW

• Psychiatry Physician in Mansfield Center, CT
• Providers in Mansfield Center, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.