Individual provider Active NPI

Bhagya Lakshmi Papudesu, M.D.

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1922059740
Registry record updated Mar 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50072 Issued in KY
Practice address
8019 Dixie Hwy Ste 101
Louisville, KY 40258-1303
Phone
(502) 333-3121
Fax
(502) 333-3131
NPI assigned
May 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 052613 GA
Internal Medicine Physician 207R00000X 50072 KY Primary

Addresses

Primary practice location

8019 Dixie Hwy Ste 101
Louisville, KY 40258-1303

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (502) 333-3121

Other practice location 1

3939 7th Street Rd
Louisville, KY 40216-4103
Phone (502) 883-6800

Other identifiers 3

IdentifierTypeStateIssuer
052613OtherGAPROVIDER MEDICAL LICENSE
111918OtherGAFQHC CMS CERT NUMBER
111825OtherGAFQHC CMS CERT NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20060721000169 GA Practitioner - Internal Medicine 6709899511 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Georgia Holding, LLC CurrentSince Dec 22, 2022 Accepting new patients

Locations

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

1325 Ralph David Abernathy Blvd SW
Atlanta, GA 30310
Phone (404) 419-0184

3371 Buford Hwy NE
Brookhaven, GA 30329
Phone (404) 419-0180

2124 Candler Rd
Decatur, GA 30032
Phone (404) 836-0272

2084 Headland Dr
East Point, GA 30344
Phone (404) 419-0184

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1922059740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "502-333-3121",
            "fax_number": "502-333-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8019 DIXIE HWY STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402581303",
            "telephone_number": "502-333-3121",
            "fax_number": "502-333-3131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3939 7th Street Rd",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402164103",
            "country_code": "US",
            "telephone_number": "502-883-6800",
            "fax_number": "502-384-1359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAPUDESU",
        "first_name": "BHAGYA",
        "middle_name": "LAKSHMI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "052613",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "50072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER MEDICAL LICENSE",
            "identifier": "052613",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FQHC CMS CERT NUMBER",
            "identifier": "111918",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FQHC CMS CERT NUMBER",
            "identifier": "111825",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.