Individual provider Active NPI

Shrenika Gunukula Reddy, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Festus, MO
National Provider Identifier
1801258207
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
2021046251 Issued in MO
Practice address
1400 US Highway 61 Ste 210
Festus, MO 63028-4141
Phone
(636) 933-8880
Fax
(636) 933-8881
NPI assigned
Mar 24, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X 2021046251 MO Primary

Addresses

Primary practice location

1400 US Highway 61 Ste 210
Festus, MO 63028-4141

Mailing address

1400 US Highway 61 Ste 210
Festus, MO 63028-4141
Phone (636) 933-8880

Other names 1

  • Sri Shrenika Shourie Edla Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20211202002327 MO Practitioner - Endocrinology 9032405238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

1400 US Hwy 61
Suite 210
Festus, MO 63028-4141
Phone (636) 933-8880

Hospital & facility affiliations

  • Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023
  • Mercy Hospital Perry Hospital, Perryville, MO, CCN 261311
  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Parkland Health Center Hospital, Farmington, MO, CCN 260163

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021046251MOMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Single Specialty CurrentSince Dec 6, 2021 Accepting new patients
Mercy Hospital Jefferson Single Specialty Past Accepting new patients

Locations

1400 US Highway 61
Ste 210
Crystal Cty, MO 63028
Phone (636) 933-8050

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

Interoperability endpoints

  • Direct secure messaging: sreddy1215820@directc.mercy.net
  • Direct secure messaging: sreddy91543@direct.phhs.org

Organizations & group practices 2

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 7

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": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1801258207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 US HIGHWAY 61 STE 210",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284141",
            "telephone_number": "636-933-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 US HIGHWAY 61 STE 210",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284141",
            "telephone_number": "636-933-8880",
            "fax_number": "636-933-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "SHRENIKA",
        "middle_name": "GUNUKULA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MO",
            "license": "2021046251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SRI SHRENIKA SHOURIE",
            "last_name": "EDLA",
            "credential": "M.B.B.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.