Active NPI
Shivaprakash T Kudlapur, MD
- Internal Medicine Physician
- Logan, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35065974K
- Practice address
- 30381 Chieftain Dr
Logan, OH 43138-9092 - Phone
- (740) 385-2555
- Fax
- (740) 380-3750
- NPI assigned
- Sep 12, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35065974K | OH | Primary |
Addresses
Primary practice location
30381 Chieftain Dr
Logan, OH 43138-9092
Mailing address
PO Box 188
Chillicothe, OH 45601-0188
Phone (740) 773-4366
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0965728 | Medicaid | OH | |
| 311155352 | Other | E V BENEFITS | |
| 311155352 | Other | OH | OHIO HEALTH CHOICE |
| 311155352 | Other | AETNA | |
| P00084899 | Other | RAILROAD MEDICARE | |
| 0408409 | Other | UNITED HEALTHCARE | |
| 311155352 | Other | CIGNA/CONN GENERAL | |
| 311155352 | Other | PPO NEXT | |
| 311155352 | Other | TRICARE | |
| 311155352 | Other | CENTRAL BENEFITS | |
| 000000300069 | Other | OH | ANTHEM |
| 311155352 | Other | EMERALD HEALTH | |
| 311155352 | Other | GREAT WEST |
Other names 1
- Prakash T Kudlapur
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1049 Western Ave
Chillicothe, OH 45601-1104
Phone (740) 773-4366
30381 Chieftain Dr
Logan, OH 43138-9092
Phone (740) 385-2555
Hospital & facility affiliations
- Caretenders Vna
- Hocking Valley Community Hospital
- Fairfield Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hopewell Health Centers Inc | Current | Accepting new patients | |
| Hopewell Health Centers Inc | Current | Accepting new patients | |
| Hocking Valley Medical Group Transportation | Past | Accepting new patients |
Locations
90 Hospital Dr
Athens, OH 45701
Phone (740) 592-3091
1049 Western Ave
Chillicothe, OH 45601
Phone (740) 773-1006
601 State Route 664 N
Logan, OH 43138
Phone (740) 380-8000
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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Athens, OH
- NPI 1699010348
-
- Primary Care Clinic/Center
- Chillicothe, OH
- NPI 1659468908
-
- Non-emergency Medical Transport (VAN)
- Logan, OH
- NPI 1417555087
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Lancaster, OH
- NPI 1740434067
-
- General Acute Care Hospital
- Lancaster, OH
- NPI 1467433763
-
- Critical Access Hospital
- Logan, OH
- NPI 1295840007
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572998400000",
"number": "1891780326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 188",
"city": "CHILLICOTHE",
"state": "OH",
"postal_code": "456010188",
"telephone_number": "740-773-4366",
"fax_number": "740-775-7855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30381 CHIEFTAIN DR",
"city": "LOGAN",
"state": "OH",
"postal_code": "431389092",
"telephone_number": "740-385-2555",
"fax_number": "740-380-3750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUDLAPUR",
"first_name": "SHIVAPRAKASH",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-12",
"last_updated": "2019-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35065974K",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0965728",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "E V BENEFITS",
"identifier": "311155352",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO HEALTH CHOICE",
"identifier": "311155352",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "311155352",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00084899",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0408409",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA/CONN GENERAL",
"identifier": "311155352",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PPO NEXT",
"identifier": "311155352",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "311155352",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CENTRAL BENEFITS",
"identifier": "311155352",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000300069",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMERALD HEALTH",
"identifier": "311155352",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT WEST",
"identifier": "311155352",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "PRAKASH",
"last_name": "KUDLAPUR",
"middle_name": "T",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Logan, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.
- 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.