Chaitanya Undavalli

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

343550 Issued in LA

Practice address

2900 E Texas St Ste 100
Bossier City, LA 71111-3275

Phone

(318) 606-6737

Fax

(833) 749-0343

NPI assigned

May 5, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in LA, TX2 enrollments

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 2

Specialty

Internal Medicine

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centerwell Senior Primary Care la PCGroup PAC ID 1951712280, 40 clinicians

North Texas Physician Services, PLLCGroup PAC ID 6305295429, 236 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032
• Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041
• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cundavalli223114@christushealth.direct-ci.net
• Direct secure messaging: chaitanya.undavalli.1@29601.direct.athenahealth.com
• Direct secure messaging: cundavalli345271@ahs.direct-ci.com

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.

• Centerwell Senior Primary Care (la) PC

  dba CenterWell Senior Primary Care-Bossier City

  • Internal Medicine Physician
  • Bossier City, LA
  • NPI 1760005136
  Medicare reassignment Care Compare group NPD
• North Texas Physician Services, PLLC

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1992586150
  Medicare reassignment Care Compare group
• Centerwell Senior Primary Care (la) PC

  dba CenterWell Senior Primary Care - Lake Charles

  • Internal Medicine Physician
  • Lake Charles, LA
  • NPI 1952036998
  NPD
• Centerwell Senior Primary Care (la) PC

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1235752692
  NPD (past)

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

• Christus Health Northern Louisiana

  dba Christus Shreveport-Bossier Health System

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1417950106
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Bossier Health Center

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba Willis Knighton South Hospital

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Pierremont Health Center

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation
• Christus Good Shepherd Medical Center

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1124092036
  Care Compare affiliation

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1902427651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "844-630-0700",
            "fax_number": "877-374-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 E TEXAS ST STE 100",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711113275",
            "telephone_number": "318-606-6737",
            "fax_number": "833-749-0343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11937 US Highway 271",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757083154",
            "country_code": "US",
            "telephone_number": "903-877-7253 x90387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UNDAVALLI",
        "first_name": "CHAITANYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-05",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "343550",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP20085227",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chaitanya.undavalli.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "2900 E Texas St Ste 100",
            "city": "Bossier City",
            "state": "LA",
            "country_code": "US",
            "postal_code": "711113275",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "kate.wells@uthct.edu",
            "affiliation": "N",
            "address_1": "11937 US Highway 271",
            "city": "Tyler",
            "state": "TX",
            "country_code": "US",
            "postal_code": "757083154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Keith D Tyer, CRNA
• Leanna M Tyler, FNP
• Kerri Lucken Tynes, P.A.
• Nnabugo Darlington Ukpaka, PHARM D
• Yie Lin Um
• Unlimited Alternatives to Change, LLC
• Tiffany Cathleen Luse Upshaw, PHARM.D.
• Usv Optical Inc.
• Jill J Vance, RN
• Patrick Vance, PT

• Internal Medicine Physician in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; 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.

Verify at the official NPI Registry.