Active NPI
Kumudini M Vaidya, MD
- Physical Medicine & Rehabilitation Physician
- Chickasha, OK
National Provider Identifier
1629052964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 12249
- Practice address
- 2222 W Iowa Ave
Chickasha, OK 73018-2738 - Phone
- (405) 224-8111
- Fax
- (405) 574-7765
- NPI assigned
- Nov 30, 2005
- Last updated
- Nov 12, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 12249 | OK | Primary |
Addresses
Primary practice location
2222 W Iowa Ave
Chickasha, OK 73018-2738
Mailing address
PO Box 1069
Chickasha, OK 73023-1069
Phone (405) 224-8111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100005110A | Medicaid | OK |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12249 | OK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257984000000",
"number": "1629052964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1069",
"city": "CHICKASHA",
"state": "OK",
"postal_code": "730231069",
"telephone_number": "405-224-8111",
"fax_number": "405-574-7765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2222 W IOWA AVE",
"city": "CHICKASHA",
"state": "OK",
"postal_code": "730182738",
"telephone_number": "405-224-8111",
"fax_number": "405-574-7765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAIDYA",
"first_name": "KUMUDINI",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-30",
"last_updated": "2009-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "OK",
"license": "12249",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100005110A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chickasha, OK
- Totaldose Chickasha LLC (Grand Care Pharmacy)
- Curtis Paul Townsend, RPH
- Traditions Health Care of Chickasha, LLC (Traditions Health of Western Oklahoma)
- David Albert Trevino Jr.
- Rory Troub Wiederstein, DC
- Valir Outpatient Clinic #17 LLC
- John C Vallandigham, M.D.
- Lee Vanderlugt, DO
- Richard W Varley, O.D.
- Paula M Veach
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.