Individual provider Active NPI

Prethi Vaddadi, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Memphis, TN
National Provider Identifier
1780810614
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
50637 Issued in TN
Practice address
3265 Point Hill CV
Memphis, TN 38125-8890
Phone
(901) 573-6638
NPI assigned
Jun 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME127432 FL
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X 23795 MS
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X 50637 TN Primary

Addresses

Primary practice location

3265 Point Hill CV
Memphis, TN 38125-8890

Mailing address

3265 Point Hill CV
Memphis, TN 38125-8890
Phone (901) 573-6638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160816002092 FL Practitioner - Obstetrics/Gynecology 5698908929
I20181218001699 MS Practitioner - Obstetrics/Gynecology 5698908929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Obhg Mississippi PCGroup PAC ID 7416120407, 29 clinicians

Practice addresses (Care Compare)

200 Hwy 30 W
New Albany, MS 38652-3112
Phone (864) 908-3530

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50637TNMDFemale Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Mississippi, P.C. CurrentSince Mar 30, 2023 Accepting new patients
Baptist Memorial Hospital Union County, Inc. Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

200 State Highway 30 W
New Albany, MS 38652
Phone (601) 534-7631

Organizations & group practices 3

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": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1780810614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3265 POINT HILL CV",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258890",
            "telephone_number": "901-573-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3265 POINT HILL CV",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258890",
            "telephone_number": "901-573-6638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADDADI",
        "first_name": "PRETHI",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-05",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME127432",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "MS",
            "license": "23795",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "TN",
            "license": "50637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.