Individual provider Active NPI

Krishna Reddy Bhaghayath, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Henderson, NC
National Provider Identifier
1619071065
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
12642 Issued in NH
Practice address
120 Charles Rollins Rd
Suite 206
Henderson, NC 27536-2882
Phone
(252) 436-6240
Fax
(252) 492-5707
NPI assigned
Sep 7, 2006
Last updated
Jul 2, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 12642 NH Primary

Addresses

Primary practice location

120 Charles Rollins Rd
Suite 206
Henderson, NC 27536-2882

Mailing address

120 Charles Rollins Rd
Suite 206
Henderson, NC 27536-2882
Phone (252) 436-6240

Other identifiers 2

IdentifierTypeStateIssuer
30205244MedicaidNH
3078651MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Maria Parham Physician Practices, LLC CurrentSince Jul 21, 2014 Accepting new patients
DLP Maria Parham Physician Practices LLC CurrentSince Jul 21, 2014 Accepting new patients
DLP Wilson Physician Practices LLC CurrentSince Oct 22, 2016 Accepting new patients
DLP Wilson Physician Practices LLC CurrentSince Oct 22, 2016 Accepting new patients

Locations

120 Charles Rollins Rd
Ste 105
Henderson, NC 27536
Phone (252) 438-2773

120 Charles Rollins Rd
Ste 206
Henderson, NC 27536
Phone (252) 433-0430

1700 Tarboro St W
Ste 103
Wilson, NC 27893
Phone (252) 293-9898

1700 Tarboro St W
Ste 200
Wilson, NC 27893
Phone (252) 399-5310

2605 Forest Hills Rd SW
Ste A
Wilson, NC 27893
Phone (252) 243-0043

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Organizations & group practices 4

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1619071065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CHARLES ROLLINS RD",
            "address_2": "SUITE 206",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362882",
            "telephone_number": "252-436-6240",
            "fax_number": "252-492-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CHARLES ROLLINS RD",
            "address_2": "SUITE 206",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362882",
            "telephone_number": "252-436-6240",
            "fax_number": "252-492-5707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAGHAYATH",
        "first_name": "KRISHNA",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NH",
            "license": "12642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30205244",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3078651",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NC

Sources for this page

Verify at the official NPI Registry.