Individual provider Active NPI

Lakshmi Kumari Avala, MD

  • Pediatrics Physician
  • Roseville, CA
National Provider Identifier
1962473686
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A79103 Issued in CA
Practice address
902 Cirby Way
Roseville, CA 95661-4420
Phone
(916) 789-1798
Fax
(916) 789-0889
NPI assigned
Jan 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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 A79103 CA Primary

Addresses

Primary practice location

902 Cirby Way
Roseville, CA 95661-4420

Mailing address

902 Cirby Way
Roseville, CA 95661-4420
Phone (916) 789-1798

Other identifiers 1

IdentifierTypeStateIssuer
2146331MedicaidCA

Other names 1

  • Mrs. Lakshmi Kumari Voodi 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
A79103CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakshmi K Avala MD Inc Pediatrics Current Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

6341 Auburn Blvd
Ste A
Citrus Heights, CA 95621

6000 Fairway Dr
Ste 3
Rocklin, CA 95677

Interoperability endpoints

  • Direct secure messaging: lavala18300@hisp.ehr.sutterhealth.org

Organizations & group practices 2

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": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1962473686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 CIRBY WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614420",
            "telephone_number": "916-789-1798",
            "fax_number": "916-789-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 CIRBY WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614420",
            "telephone_number": "916-789-1798",
            "fax_number": "916-789-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVALA",
        "first_name": "LAKSHMI",
        "middle_name": "KUMARI",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A79103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2146331",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAKSHMI",
            "last_name": "VOODI",
            "middle_name": "KUMARI",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; 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.