Renjithkumar Kalikkot Thekkeveedu, MD

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

24321 Issued in MS

Practice address

2500 N State St
Jackson, MS 39216-4500

Phone

(601) 984-5262

NPI assigned

May 3, 2012

Last updated

Feb 22, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Methodist Health, Inc.

  dba Deaconess Henderson Hospital Providers

  • Hospitalist Physician
  • Henderson, KY
  • NPI 1679718100

  Neonatal-Perinatal Medicine

  Medicare reassignment NPD
• Methodist Health, Inc.

  dba Deaconess Henderson Pediatrics Elm St

  • Pediatrics Physician
  • Henderson, KY
  • NPI 1457784126
  NPD
• Methodist Health, Inc.

  dba Deaconess Henderson Pain Services

  • Pain Clinic/Center
  • Henderson, KY
  • NPI 1780249060
  NPD
• Methodist Health, Inc.

  dba Deaconess Henderson Hospital

  • General Acute Care Hospital
  • Henderson, KY
  • NPI 1083759633
  NPD (past)

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1851659353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4199 Gateway Blvd",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476308940",
            "country_code": "US",
            "telephone_number": "812-842-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALIKKOT THEKKEVEEDU",
        "first_name": "RENJITHKUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-03",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IN",
            "license": "01089483A",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MS",
            "license": "24321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07800040",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Libby Gathei Kabachia
• Mahrukh Kadri
• Kahak Ms Inc
• Kollin Kahler
• Monica Divya Kala, MD
• Grant Haik Kalil, MD
• Wendy Kalimeris, LPTA
• William Kalusche
• Anne Catherine Kane
• Jannat Kang, MD

• Neonatal-Perinatal Medicine Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Neonatal-Perinatal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.