NPIMap

Individual provider Active NPI

Shilpa Kala Sannapaneni, MD

  • Internal Medicine Physician
  • Provo, UT
National Provider Identifier
1902303522
Registry record updated May 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301508115 Issued in MI
Practice address
395 W Cougar Blvd Ste 602
Provo, UT 84604-3331
Phone
(801) 357-0570
NPI assigned
Apr 10, 2018
Last updated
May 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 4301508115 MI
Internal Medicine Physician 207R00000X 4301508115 MI Primary

Addresses

Primary practice location

395 W Cougar Blvd Ste 602
Provo, UT 84604-3331

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 357-0570

Other names 1

  • Dr. Shilpa Kala Sannapaneni Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, UT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230622001636 MI Practitioner - Internal Medicine 4385045350 Reassigns benefits to 1 organization
I20250722000775 UT Practitioner - Internal Medicine 4385045350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

395 W Bulldog Blvd
Suite 602
Provo, UT 84604-3331
Phone (801) 357-0570

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301508115MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Aug 17, 2025 Accepting new patients
Ihc Health Services Inc CurrentSince Aug 17, 2025 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Dedicated Physicians Group of Michigan PLLC CurrentSince Jun 1, 2023 Accepting new patients
Dedicated Physicians Group of Michigan, PLLC Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
Dedicated Physicians Group of Michigan PLLC PastSince Mar 28, 2021 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

13210 E Jefferson Ave
Detroit, MI 48215
Phone (313) 335-3444

21816 W 11 Mile Rd
Southfield, MI 48076
Phone (248) 375-4040

21832 W 11 Mile Rd
Southfield, MI 48076
Phone (248) 375-4040

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

395 W Cougar Blvd
Ste 602
Provo, UT 84604
Phone (801) 357-0570

Interoperability endpoints

  • Direct secure messaging: ssannapaneni828186@direct.sw.org
  • Direct secure messaging: ssannapaneni985483@direct.hfhs.org

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748217600000",
    "number": "1902303522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-357-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W COUGAR BLVD STE 602",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043331",
            "telephone_number": "801-357-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANNAPANENI",
        "first_name": "SHILPA",
        "middle_name": "KALA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2025-05-26",
        "certification_date": "2025-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301508115",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301508115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHILPA",
            "last_name": "SANNAPANENI",
            "middle_name": "KALA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.