Individual provider Active NPI

Raveena Nalla, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Olive Branch, MS
National Provider Identifier
1679095772
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
29883 Issued in MS
Practice address
5480 Goodman Rd Ste 1
Olive Branch, MS 38654-7902
Phone
(662) 874-6507
Fax
(662) 932-8197
NPI assigned
Jul 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 29883 MS Primary

Addresses

Primary practice location

5480 Goodman Rd Ste 1
Olive Branch, MS 38654-7902

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655

Other practice location 1

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-5726

Other practice location 2

300 2nd Ave
Long Branch, NJ 07740-6303
Phone (732) 923-6540

Other practice location 3

81 Ed Perry Blvd Ste 105
Oxford, MS 38655-3465
Phone (662) 636-5335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20220804001767 MS Practitioner - Endocrinology 4385026574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Memorial Medical Group, Inc.Group PAC ID 5193610228, 581 clinicians

Practice addresses (Care Compare)

255 Baptist Blvd
Columbus, MS 39705-2006

551 Azalea Dr
Oxford, MS 38655-7900
Phone (662) 636-5335

PO Box
Suite 405827
Atlanta, GA 30384-5827

Hospital & facility affiliations

  • Baptist Memorial Hospital North Ms Hospital, Oxford, MS, CCN 250034
  • University of Mississippi Medical Center- Grenada Hospital, Grenada, MS, CCN 250168
  • Baptist Memorial Hospital Union County Hospital, New Albany, MS, CCN 250006
  • North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004
  • BMH-Calhoun Hospital, Calhoun City, MS, CCN 251331

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc CurrentSince Sep 1, 2022 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Sep 1, 2022 Accepting new patients

Locations

255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288

81 Ed Perry Blvd
Ste 105
Oxford, MS 38655
Phone (662) 636-5335

551 Azalea Dr
Oxford, MS 38655
Phone (662) 234-0332

965 Ridge Lake Blvd
Ste 315
Memphis, TN 38120
Phone (877) 348-1281

Interoperability endpoints

  • Direct secure messaging: rnalla539396@direct.bmhcc.org

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 and National Provider Directory roles.

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": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1679095772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 GOODMAN RD STE 1",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386547902",
            "telephone_number": "662-874-6507",
            "fax_number": "662-932-8197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 E Adams St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132102306",
            "country_code": "US",
            "telephone_number": "315-464-5726",
            "fax_number": "315-464-2510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Long Branch",
            "state": "NJ",
            "postal_code": "077406303",
            "country_code": "US",
            "telephone_number": "732-923-6540",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "81 Ed Perry Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MS",
            "postal_code": "386553465",
            "country_code": "US",
            "telephone_number": "662-636-5335",
            "fax_number": "662-636-5337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NALLA",
        "first_name": "RAVEENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MS",
            "license": "29883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

Verify at the official NPI Registry.