Individual provider Active NPI

Krupavathi Maramreddy, MD

  • Pediatrics Physician
  • Waycross, GA
National Provider Identifier
1629148069
Registry record updated Jul 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20129 Issued in GA
Practice address
218 Quarterman St
Waycross, GA 31501-3547
Phone
(912) 287-0301
Fax
(912) 287-1568
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 20129 GA
Pediatrics Physician 208000000X 20129 GA Primary

Addresses

Primary practice location

218 Quarterman St
Waycross, GA 31501-3547

Mailing address

218 Quarterman St
Waycross, GA 31501-3547
Phone (912) 287-0301

Other identifiers 1

IdentifierTypeStateIssuer
000191001FMedicaidGA

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

LicenseStateTypeSpecialty
20129GAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
McKinney Community Health Ctr, Inc Past Accepting new patients

Organizations & group practices 1

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373500800000",
    "number": "1629148069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 QUARTERMAN ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315013547",
            "telephone_number": "912-287-0301",
            "fax_number": "912-287-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 QUARTERMAN ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315013547",
            "telephone_number": "912-287-0301",
            "fax_number": "912-287-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAMREDDY",
        "first_name": "KRUPAVATHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2013-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "20129",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "20129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000191001F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.