Active NPI
Marandapalli R Jayaram, MD
- Pediatrics Physician
- Kansas City, KS
National Provider Identifier
1922056423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0415262
- Practice address
- 2040 Hutton Rd
Suite 102
Kansas City, KS 66109-4566 - Phone
- (913) 299-3700
- Fax
- (913) 299-3050
- NPI assigned
- May 5, 2006
- Last updated
- May 21, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0415262 | KS | Primary |
| Pediatric Cardiology Physician | 2080P0202X | 0415262 | KS |
Addresses
Primary practice location
2040 Hutton Rd
Suite 102
Kansas City, KS 66109-4566
Mailing address
5675 Roe Blvd
Ste 100
Roeland Park, KS 66205-2538
Phone (913) 432-2080
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100093650D | Medicaid | KS | |
| 100216770C | Medicaid | KS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0415262 | KS | MD | Pediatric Cardiology Physician |
Interoperability endpoints
- marandapallijayaram@smgks.allscriptsdirect.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621555200000",
"number": "1922056423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5675 ROE BLVD",
"address_2": "STE 100",
"city": "ROELAND PARK",
"state": "KS",
"postal_code": "662052538",
"telephone_number": "913-432-2080",
"fax_number": "913-432-5183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 HUTTON RD",
"address_2": "SUITE 102",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661094566",
"telephone_number": "913-299-3700",
"fax_number": "913-299-3050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAYARAM",
"first_name": "MARANDAPALLI",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2021-05-21",
"certification_date": "2021-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KS",
"license": "0415262",
"primary": true
},
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "KS",
"license": "0415262",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100093650D",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100216770C",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, KS
- Jason Wiltshire, MD, PA
- Nimra Javaid, MD
- Melissa Javellana, M.D.
- Jeffrey John Villareal Javier, DNP, APRN, FNP-C
- Omar Jawdat, MD
- Jayhawk Primary Care Inc (State Avenue Health Care)
- Jayhawk Primary Care Inc
- Jayhawk Primary Care Inc
- Jayhawk Primary Care Inc (State Avenue Urgent Care)
- Jayhawk Primary Care Inc (State Avenue Therapy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.