NPIMap

Individual provider Active NPI

Venkatachala Nagappa Vitalpur, M.D

  • Internal Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1902974843
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01029983A Issued in IN
Practice address
2431 Barcroft CT
Fort Wayne, IN 46804-5252
Phone
(260) 432-1659
Fax
(260) 432-1659
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01029983A IN Primary

Addresses

Primary practice location

2431 Barcroft CT
Fort Wayne, IN 46804-5252

Mailing address

2431 Barcroft CT
Fort Wayne, IN 46804-5252
Phone (260) 432-1659

Other names 1

  • Dr. Vitalapura Nagappa Venkatachala Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01029983AINMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902974843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 BARCROFT CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045252",
            "telephone_number": "260-432-1659",
            "fax_number": "260-432-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 BARCROFT CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045252",
            "telephone_number": "260-432-1659",
            "fax_number": "260-432-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALPUR",
        "first_name": "VENKATACHALA",
        "middle_name": "NAGAPPA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01029983A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VITALAPURA",
            "last_name": "VENKATACHALA",
            "middle_name": "NAGAPPA",
            "prefix": "DR.",
            "credential": "M.D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.