Individual provider Active NPI

Vidyasagar Gurram Reddy

  • Emergency Medicine Physician
  • Carthage, TX
National Provider Identifier
1598719973
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
L8915 Issued in TX
Practice address
409 Cottage Rd
Carthage, TX 75633-1466
Phone
(903) 253-2485
NPI assigned
May 20, 2006
Last updated
Nov 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X L8915 TX Primary

Addresses

Primary practice location

409 Cottage Rd
Carthage, TX 75633-1466

Mailing address

3411 Storey Lake Dr
Tyler, TX 75707-1761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040805000642 TX Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 6204807860 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000935NYMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ess of South Texas LLC Emergency Medicine CurrentSince Mar 23, 2023 Accepting new patients
Wellness & Care Group of Texas, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Ess of Fairfield LLC Emergency Medicine CurrentSince Mar 1, 2023 Accepting new patients
Ess of Crockett, LLC Emergency Medicine CurrentSince Mar 23, 2023 Accepting new patients
CMC Radiological Services PC Past Accepting new patients
CMC Radiological Services PC Past Accepting new patients
Wood Emergency Medicine Associates PA Emergency Medicine Past Accepting new patients

Locations

100 Medical Dr
Borger, TX 79007
Phone (806) 273-1100

1100 E Loop 304
Crockett, TX 75835
Phone (936) 546-3862

125 Newman St
Fairfield, TX 75840
Phone (888) 250-2326

21175 Tomball Pkwy
Houston, TX 77070
Phone (281) 251-5544

1353 N Travis St
Liberty, TX 77575
Phone (936) 336-7316

22625 State Highway 249
Ste 450
Tomball, TX 77375
Phone (214) 506-1136

Interoperability endpoints

  • Direct secure messaging: fmcvreddy@yourcarecommunity.org
  • Direct secure messaging: vreddy355371@ahs.direct-ci.com

Organizations & group practices 7

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1598719973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 STOREY LAKE DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757071761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 COTTAGE RD",
            "city": "CARTHAGE",
            "state": "TX",
            "postal_code": "756331466",
            "telephone_number": "903-253-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "VIDYASAGAR",
        "middle_name": "GURRAM",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L8915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, TX

Sources for this page

Verify at the official NPI Registry.