Individual provider Active NPI

Srikanth Kolli

  • Chiropractor
  • Olivehurst, CA
National Provider Identifier
1790229391
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
33448 Issued in CA
Practice address
4941 Olivehurst Ave
Olivehurst, CA 95961-4225
Phone
(530) 743-4611
NPI assigned
Dec 15, 2016
Last updated
Mar 22, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 33448 CA Primary

Addresses

Primary practice location

4941 Olivehurst Ave
Olivehurst, CA 95961-4225

Mailing address

4941 Olivehurst Ave
Olivehurst, CA 95961-4225
Phone (530) 743-4611

Other practice location 1

1000 Sutter St
Yuba City, CA 95991-3459
Phone (530) 673-9420

Other practice location 2

700 Bogue Rd Apt 138
Yuba City, CA 95991-9240
Phone (812) 322-1806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170111003574 CA Practitioner - Chiropractic 9739460403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ampla HealthGroup PAC ID 5092619270, 105 clinicians

Practice addresses (Care Compare)

4941 Olivehurst Ave
Olivehurst, CA 95961-4225
Phone (530) 743-4611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33448CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ampla Health CurrentSince Feb 27, 2017 Accepting new patients
Ampla Health CurrentSince Feb 27, 2017 Accepting new patients
Ampla Health Current Accepting new patients

Locations

4941 Olivehurst Ave
Olivehurst, CA 95961
Phone (530) 743-4611

2800 Lincoln St
Oroville, CA 95966
Phone (530) 534-7500

1000 Sutter St
Yuba City, CA 95991
Phone (530) 673-9420

935 Market St
Yuba City, CA 95991
Phone (530) 674-4261

Interoperability endpoints

  • Direct secure messaging: srikanth.kolli@ampla.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1790229391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4941 OLIVEHURST AVE",
            "city": "OLIVEHURST",
            "state": "CA",
            "postal_code": "959614225",
            "telephone_number": "530-743-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4941 OLIVEHURST AVE",
            "city": "OLIVEHURST",
            "state": "CA",
            "postal_code": "959614225",
            "telephone_number": "530-743-4611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Sutter St",
            "address_purpose": "LOCATION",
            "city": "Yuba City",
            "state": "CA",
            "postal_code": "959913459",
            "country_code": "US",
            "telephone_number": "530-673-9420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Bogue Rd Apt 138",
            "address_purpose": "LOCATION",
            "city": "Yuba City",
            "state": "CA",
            "postal_code": "959919240",
            "country_code": "US",
            "telephone_number": "812-322-1806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLLI",
        "first_name": "SRIKANTH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-15",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olivehurst, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.