Sreedhar Reddy Mitta

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2022030304 Issued in MO

Practice address

2425 Fairlawn Dr
Carthage, MO 64836-3517

Phone

(417) 237-0983

NPI assigned

Sep 5, 2019

Last updated

Aug 16, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smitta1309462@directc.mercy.net

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.

• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1215264817
  Medicare reassignment NPD
• Mercy Hospital Carthage

  • Critical Access Hospital
  • Carthage, MO
  • NPI 1003201955
  Medicare reassignment NPD
• Detroit Medical Center

  dba Tenet Health Care

  • Student in an Organized Health Care Education/Training Program
  • Detroit, MI
  • NPI 1699327429
  NPD Authorized official
• Mercy Hospital Carthage

  dba Mercy Hospital Carthage - Pediatrics

  • Rural Health Clinic/Center
  • Carthage, MO
  • NPI 1285904342

  Pediatrics

  NPD
• Mercy Hospital Carthage

  • Family Medicine Physician
  • Carthage, MO
  • NPI 1558628222

  Pediatrics

  NPD
• Mercy Hospital Joplin

  • General Acute Care Hospital
  • Joplin, MO
  • NPI 1700112745
  NPD (past)

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1902455504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 FAIRLAWN DR",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648363517",
            "telephone_number": "417-237-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 FAIRLAWN DR",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648363517",
            "telephone_number": "417-237-0983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTA",
        "first_name": "SREEDHAR REDDY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-05",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4351045516",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2022030304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mercy Hospital Carthage (Mercy Hospital Carthage - Women's Health)
• Edward Dean Messer, CRNA
• Brianna Meyer, R.D.H.
• Zaki Minas, DMD
• Andrea Mitchell
• Micah Moore
• Wendy Mulder, NP
• Isaac Murphy, DC
• Neurological Associates of the Four States
• Dung T Nguyen

• Pediatrics Physician in Carthage, MO
• Providers in Carthage, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.