NPIMap

Individual provider Active NPI

Venkata Praveen Kondreddi, M.D.

  • Internal Medicine Physician
  • Lima, OH
National Provider Identifier
1710135389
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35095474 Issued in OH
Practice address
1001 Bellefontaine Avenue
Lima, OH 45804-2800
Phone
(419) 998-4694
NPI assigned
Sep 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35095474 OH Primary

Addresses

Primary practice location

1001 Bellefontaine Avenue
Lima, OH 45804-2800

Mailing address

104 Clintwood CT Apt D
Rochester, NY 14620-3555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100810000264 OH Practitioner - Internal Medicine 3173657376 Reassigns benefits to 1 organization
I20160513000239 NC Practitioner - Internal Medicine 3173657376 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35095474OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Sep 1, 2018 Accepting new patients
Apogee Medical Group Ohio Inc Internal Medicine CurrentSince Aug 1, 2010 Accepting new patients
Wake Forest University Health Sciences CurrentSince Sep 1, 2018 Accepting new patients
High Point Regional Health Internal Medicine CurrentSince Apr 1, 2016 Accepting new patients
High Point Regional Health Current Accepting new patients
Apogee Medical Group Virginia, PC Internal Medicine Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

319 Westwood Ave
Uppr
High Point, NC 27262
Phone (336) 878-6419

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

1001 Bellefontaine Ave
Lima, OH 45804
Phone (419) 228-3335

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

320 Hospital Dr
Martinsville, VA 24112
Phone (276) 666-7200

Interoperability endpoints

  • Direct secure messaging: vkondreddi2754054@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1710135389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CLINTWOOD CT APT D",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146203555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BELLEFONTAINE AVENUE",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458042800",
            "telephone_number": "419-998-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDREDDI",
        "first_name": "VENKATA PRAVEEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-08",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35095474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.