Kingsley Prakash Anand Pudota, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

2015-02195 Issued in NC

Practice address

3110 Maccorkle Ave SE
Charleston, WV 25304-1210

Phone

(304) 388-5590

Fax

(304) 388-8238

NPI assigned

Jun 7, 2011

Last updated

Sep 9, 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 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

HospitalistAlso: Internal Medicine

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Moses Cone Physician Services, IncGroup PAC ID 4284782210, 397 clinicians

Cogent Healthcare of North Carolina PCGroup PAC ID 7911954714, 66 clinicians

North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unc Health Johnston Home Care and Hospice Home health agency, Smithfield, NC, CCN 347105
• Johnston Health Hospital, Smithfield, NC, CCN 340090
• Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091
• Alamance Regional Medical Center Hospital, Burlington, NC, CCN 340070
• Select Specialty Hospital Durham Inc Long-term care hospital, Durham, NC, CCN 342018

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpudota334575@direct.unc.nchie.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.

• Cogent Healthcare of North Carolina, PC

  • Internal Medicine Physician
  • Rocky Mount, NC
  • NPI 1548207483
  Medicare reassignment Care Compare group NPD
• Moses Cone Physician Services, Inc.

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1093953127
  Medicare reassignment Care Compare group NPD
• North Carolina MG, LLC

  dba UNC Health North Carolina Heart and Vascular

  • Hospitalist Physician
  • Raleigh, NC
  • NPI 1215741640
  Medicare reassignment Care Compare group NPD
• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment Care Compare group NPD
• Apogee Medical Group North Carolina

  • Hospitalist Physician
  • Scottsdale, AZ
  • NPI 1043518228

  NC

  Medicare reassignment NPD
• Select Specialty Hospital - Greensboro Inc.

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1912205113
  Medicare reassignment NPD
• Moses Cone Physician Services Inc

  dba Triad Hospitalists

  • Hospitalist Physician
  • Greensboro, NC
  • NPI 1326363383
  NPD
• Select Specialty Hospital - Greensboro Inc

  • Long Term Care Hospital
  • Greensboro, NC
  • NPI 1730346784
  NPD
• Rex Hospital Inc

  dba North Carolina Heart and Vascular

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1972939643
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alamance Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Burlington, NC
  • NPI 1326010273
  Care Compare affiliation
• Johnston Health Services Corporation

  dba Johnston Health

  • General Acute Care Hospital
  • Smithfield, NC
  • NPI 1619911104
  Care Compare affiliation
• Johnston Health Services Corporation

  dba Johnston Health Home Care and Hospice

  • Home Health Agency
  • Smithfield, NC
  • NPI 1902845928
  Care Compare affiliation
• Select Specialty Hospital - Durham Inc

  • Long Term Care Hospital
  • Durham, NC
  • NPI 1306845482

  Long-term care hospital

  Care Compare affiliation
• The Moses H. Cone Memorial Hospital Operating Corporation

  • General Acute Care Hospital
  • Greensboro, NC
  • NPI 1477591055
  Care Compare affiliation

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1942594924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041210",
            "telephone_number": "304-388-5590",
            "fax_number": "304-388-8238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041210",
            "telephone_number": "304-388-5590",
            "fax_number": "304-388-8238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 N Brightleaf Blvd",
            "address_purpose": "LOCATION",
            "city": "Smithfield",
            "state": "NC",
            "postal_code": "275774407",
            "country_code": "US",
            "telephone_number": "919-938-7189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUDOTA",
        "first_name": "KINGSLEY",
        "middle_name": "PRAKASH ANAND",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-07",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101256996",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2015-02195",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "25957",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2015-02195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpudota334575@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "509 N Brightleaf Blvd",
            "city": "Smithfield",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275774407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristin Paige Pruitt, MA, NCC, LPC
• Jori Pryor
• Psimed Oasis, LLC (Oasis, LLC)
• Michaela Puckett
• Rosanna Puckett
• Kyle Pugh
• Payton Pugh
• Paul Puglisi
• Fred T. Pulido Jr., M.D.
• Barbara Ann Pullen

• Hospitalist Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• Hospitalist Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.