Individual provider Active NPI

Venkata Bharadwaj Kolli, MBBS

  • Psychiatry Physician
  • Omaha, NE
National Provider Identifier
1629382148
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
6389 Issued in NE
Practice address
985582 Nebraska Medical Ctr
Department of Psychiatry
Omaha, NE 68198-5582
Phone
(402) 717-5550
NPI assigned
Jul 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 6389 NE Primary

Addresses

Primary practice location

985582 Nebraska Medical Ctr
Department of Psychiatry
Omaha, NE 68198-5582

Mailing address

9222 Burt St
Apt:118
Omaha, NE 68114-2479
Phone (402) 717-5550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20150623000397 NE Practitioner - Psychiatry 7719118371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faith Regional Physician Services LLCGroup PAC ID 5193786168, 194 clinicians

Practice addresses (Care Compare)

2700 W Norfolk Ave
Faith Regional Health Services
Norfolk, NE 68701-4438
Phone (402) 371-4880

Hospital & facility affiliations

  • Faith Health Hospital, Norfolk, NE, CCN 280125

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6389NEMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Community Hospital Inc Current Accepting new patients
Faith Regional Physician Services, LLC CurrentSince Oct 6, 2022 Accepting new patients
Faith Regional Physician Services, LLC Psychiatry CurrentSince Oct 6, 2022 Accepting new patients
Children'S Hospital & Medical Center Past Accepting new patients
Faith Regional Health Services Past Accepting new patients

Locations

4600 38th St
Columbus, NE 68601
Phone (402) 562-3333

47452 268 Ave
Ste C
Humphrey, NE 68642
Phone (402) 923-0150

2700 W Norfolk Ave
Norfolk, NE 68701
Phone (402) 644-7131

2600 W Norfolk Ave
Ste 200
Norfolk, NE 68701
Phone (402) 844-8194

Interoperability endpoints

  • Direct secure messaging: vkolli24093@direct.nebraskamed.com
  • Direct secure messaging: vkolli45884@achce.catholichealth.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1629382148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9222 BURT ST",
            "address_2": "APT:118",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142479",
            "telephone_number": "402-717-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985582 NEBRASKA MEDICAL CTR",
            "address_2": "DEPARTMENT OF PSYCHIATRY",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681985582",
            "telephone_number": "402-717-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLI",
        "first_name": "VENKATA",
        "middle_name": "BHARADWAJ",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-27",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NE",
            "license": "6389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.