Individual provider Active NPI

Rajyalakshmi Gonuguntla Naidu, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Saint Louis, MO
National Provider Identifier
1740400886
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
R9756 Issued in MO
Practice address
6420 Clayton Rd
St Marys Health Center
Saint Louis, MO 63117-1811
Phone
(314) 768-8202
Fax
(314) 768-7145
NPI assigned
Apr 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X R9756 MO Primary

Addresses

Primary practice location

6420 Clayton Rd
St Marys Health Center
Saint Louis, MO 63117-1811

Mailing address

12541 Conway Downs Drive
St Louis, MI 63141
Phone (314) 576-7114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St. Louis Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740400886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12541 CONWAY DOWNS DRIVE",
            "city": "ST LOUIS",
            "state": "MI",
            "postal_code": "63141",
            "telephone_number": "314-576-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD",
            "address_2": "ST MARYS HEALTH CENTER",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171811",
            "telephone_number": "314-768-8202",
            "fax_number": "314-768-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIDU",
        "first_name": "RAJYALAKSHMI",
        "middle_name": "GONUGUNTLA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "R9756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • 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.