Individual provider Active NPI

Sarveswararao Talla, MD

  • Pediatrics Physician
  • Southfield, MI
National Provider Identifier
1932126752
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ST039318 Issued in MI
Practice address
17356 W 12 Mile Rd
Suite 100
Southfield, MI 48076-2128
Phone
(248) 552-1220
Fax
(248) 552-8331
NPI assigned
Jul 16, 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
Pediatrics Physician 208000000X ST039318 MI Primary

Addresses

Primary practice location

17356 W 12 Mile Rd
Suite 100
Southfield, MI 48076-2128

Mailing address

17356 W 12 Mile Rd
Suite 100
Southfield, MI 48076-2128
Phone (248) 552-1220

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
ST039318MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. S.Rao Talla Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: stalla1155146@direct.hfhs.org

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932126752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17356 W 12 MILE RD",
            "address_2": "SUITE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762128",
            "telephone_number": "248-552-1220",
            "fax_number": "248-552-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17356 W 12 MILE RD",
            "address_2": "SUITE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762128",
            "telephone_number": "248-552-1220",
            "fax_number": "248-552-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLA",
        "first_name": "SARVESWARARAO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "ST039318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

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.