NPIMap

Individual provider Active NPI

Deepika Reddy Ralla, MD

  • Internal Medicine Physician
  • Shreveport, LA
National Provider Identifier
1841552338
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD12345 Issued in LA
Practice address
1501 Kings Hwy
Shreveport, LA 71103-4228
Phone
(860) 986-4098
Fax
(507) 607-8545
NPI assigned
Jun 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.206394 LA
Hematology (Internal Medicine) Physician 207RH0000X MD.206394 LA
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD12345 LA Primary

Addresses

Primary practice location

1501 Kings Hwy
Shreveport, LA 71103-4228

Mailing address

9552 Rochel Dr
Shreveport, LA 71115-3854
Phone (860) 986-4098

Other practice location 1

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800
Phone (318) 681-4138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130916000578 LA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 8325282254 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800
Phone (318) 681-4138

2539 Viking Dr
Bossier City, LA 71111-1611
Phone (318) 848-2970

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.206394LAMDInternal Medicine Physician
MD12345LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Aug 1, 2022 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Mar 25, 2016 Accepting new patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients

Locations

3330 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6917

2531 Viking Dr
Bossier City, LA 71111
Phone (318) 681-7000

4200 Nelson Rd
Lake Charles, LA 70605
Phone (318) 474-6370

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

Interoperability endpoints

  • Direct secure messaging: dralla282132@christushealth.direct-ci.net

Organizations & group practices 4

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 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1841552338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9552 ROCHEL DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711153854",
            "telephone_number": "860-986-4098",
            "fax_number": "507-607-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "860-986-4098",
            "fax_number": "507-607-8545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1453 E Bert Kouns Industrial Loop",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711056800",
            "country_code": "US",
            "telephone_number": "318-681-4138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RALLA",
        "first_name": "DEEPIKA",
        "middle_name": "REDDY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.206394",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "LA",
            "license": "MD.206394",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD12345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.