NPIMap

Individual provider Active NPI

Jagan Kothapally, M.D.

  • Nephrology Physician
  • Lynchburg, VA
National Provider Identifier
1649385733
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME115829 Issued in FL
Practice address
2091 Langhorne Rd
Lynchburg, VA 24501
Phone
(434) 947-3954
Fax
(434) 947-5944
NPI assigned
Aug 20, 2006
Last updated
Aug 7, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME115829 FL Primary

Addresses

Primary practice location

2091 Langhorne Rd
Lynchburg, VA 24501

Mailing address

2140 Kingsley Ave Ste 10
Orange Park, FL 32073-5129
Phone (904) 529-5252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130708000569 FL Practitioner - NephrologyPractitioner - Internal Medicine 1153473871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
National Kidney Partners LLPGroup PAC ID 7012981350, 63 clinicians

Practice addresses (Care Compare)

2140 Kingsley Ave
Suite 10
Orange Park, FL 32073-5129
Phone (904) 529-5252

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
National Kidney Partners, LLP Nephrology CurrentSince Nov 1, 2021 Accepting new patients
Lynchburg Nephrology Physicians PLLC Past Accepting new patients

Locations

14134 Nephron Ln
Hudson, FL 34667
Phone (727) 863-5418

2140 Kingsley Ave
Ste 10
Orange Park, FL 32073
Phone (904) 276-0005

Interoperability endpoints

  • Direct secure messaging: jkothapally78956@direct.acumenmd.com

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1649385733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 KINGSLEY AVE STE 10",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735129",
            "telephone_number": "904-529-5252",
            "fax_number": "904-529-5253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2091 LANGHORNE RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "24501",
            "telephone_number": "434-947-3954",
            "fax_number": "434-947-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTHAPALLY",
        "first_name": "JAGAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME115829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.