Active NPI
Srivalli Ganne
- Psychiatry Physician
- Jackson, MS
National Provider Identifier
1811146459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 755L
- Practice address
- 2500 N State St
Dept of Psychiatry and Behavior
Jackson, MS 39216-4500 - Phone
- (601) 815-4725
- NPI assigned
- Sep 18, 2008
- Last updated
- Aug 20, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 229921 | MA | |
| Psychiatry Physician | 2084P0800X | 755L | MS | Primary |
Addresses
Primary practice location
2500 N State St
Dept of Psychiatry and Behavior
Jackson, MS 39216-4500
Mailing address
2500 N State St
Ummc Dept of Psychiatry and Behavior
Jackson, MS 39216-4500
Phone (601) 815-4725
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 755L | MS | MD | Psychiatry Physician |
| 229921 | MA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250726400000",
"number": "1811146459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 N STATE ST",
"address_2": "UMMC DEPT OF PSYCHIATRY AND BEHAVIOR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-815-4725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 N STATE ST",
"address_2": "DEPT OF PSYCHIATRY AND BEHAVIOR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-815-4725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANNE",
"first_name": "SRIVALLI",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-18",
"last_updated": "2009-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MA",
"license": "229921",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MS",
"license": "755L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.