Vijaya L. Boppana, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

12394R Issued in LA

Practice address

242 West Shamrock Street
Pineville, LA 71360

Phone

(318) 484-6260

NPI assigned

Oct 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710063763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 TENNYSON OAKS LANE",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "71301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 WEST SHAMROCK STREET",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "71360",
            "telephone_number": "318-484-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOPPANA",
        "first_name": "VIJAYA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "12394R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538809",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Greg H Bolton, PA-C
• Deborah L Bond, LCSW
• Chelcie Lemaire Bonin
• Janet Blank Bonnette, LCSW
• Rama Boppana
• Benjamin Paul Bordelon
• Danna Dyess Bordelon, M.S.W., L.C.S.W.
• Jessica Bordelon, PHARMD.
• Sabrina Jewel Bordelon, LCSW
• Wendy Williams Bordelon, MSW, LCSW, BACS

• Psychiatry Physician in Pineville, LA
• Providers in Pineville, LA by specialty
• Psychiatry Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.