NPIMap

Individual provider Active NPI

Pradeep Reddy Thodima, MD

  • Nephrology Physician
  • Bloomington, IN
National Provider Identifier
1720376197
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
01088443A Issued in IN
Practice address
550 S Landmark Ave
Bloomington, IN 47403-3239
Phone
(812) 676-4660
Fax
(812) 676-4501
NPI assigned
Jul 19, 2011
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 01088443A IN Primary
Internal Medicine Physician 207R00000X 01088443A IN
Nephrology Physician 207RN0300X 077321 GA

Addresses

Primary practice location

550 S Landmark Ave
Bloomington, IN 47403-3239

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1200 N Jefferson St
Albany, GA 31701-2057
Phone (229) 888-3970

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pthodima@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, IN2 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
I20170418002279 GA Practitioner - Internal MedicinePractitioner - NephrologyPractitioner - Hospitalist 0143511402 Reassigns benefits to 2 organizations
I20221027001897 IN Practitioner - NephrologyPractitioner - Internal Medicine 0143511402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

550 S Landmark Ave
Indiana University So in Phy LLC
Bloomington, IN 47403-3239
Phone (888) 484-3258

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01088443AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Dec 1, 2022 Accepting new patients
Phoebe Physician Group, Inc CurrentSince Aug 1, 2019 Accepting new patients
Kidney Hypertension Clinic, PC Nephrology CurrentSince Oct 4, 2021 Accepting new patients
Indiana University Health Southern Indiana Physicians, LLC Internal Medicine CurrentSince Dec 1, 2022 Accepting new patients
Iu Health Medical Group, LLC Past Accepting new patients

Locations

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

605 Old Norcross Rd
Lawrenceville, GA 30046
Phone (770) 961-1231

550 S Landmark Ave
Bloomington, IN 47403
Phone (812) 330-3688

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

Organizations & group practices 5

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 8

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": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1720376197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474033239",
            "telephone_number": "812-676-4660",
            "fax_number": "812-676-4501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "GA",
            "postal_code": "317012057",
            "country_code": "US",
            "telephone_number": "229-888-3970",
            "fax_number": "229-888-7771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THODIMA",
        "first_name": "PRADEEP",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IN",
            "license": "01088443A",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01088443A",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "077321",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pthodima@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "550 S Landmark Ave",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474033239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.