Individual provider Active NPI

Jayasree Madi Reddi, MD

  • Psychiatry Physician
  • Goldsboro, NC
National Provider Identifier
1659456770
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
96-01450 Issued in NC
Practice address
Cherry Hospital
1401 West Ash Street
Goldsboro, NC 27530-1078
Phone
(919) 575-7211
Fax
(919) 575-7643
NPI assigned
Oct 26, 2006
Last updated
Oct 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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 96-01450 NC Primary

Addresses

Primary practice location

Cherry Hospital
1401 West Ash Street
Goldsboro, NC 27530-1078

Mailing address

Cherry Hospital
1401 West Ash Street
Goldsboro, NC 27530-1078
Phone (919) 575-7211

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

State licenses

LicenseStateTypeSpecialty
96-01450NCMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1659456770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CHERRY HOSPITAL",
            "address_2": "1401 WEST ASH STREET",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275301078",
            "telephone_number": "919-575-7211",
            "fax_number": "919-575-7643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHERRY HOSPITAL",
            "address_2": "1401 WEST ASH STREET",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275301078",
            "telephone_number": "919-575-7211",
            "fax_number": "919-575-7643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDI",
        "first_name": "JAYASREE",
        "middle_name": "MADI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "96-01450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

Verify at the official NPI Registry.