Govardhana Roa Korrapati, M.D.
Individual provider Active NPI Internal Medicine Physician · Fostoria, OH
NPI 1962494583 · NPPES record last updated Feb 23, 2015
Key facts
- NPI
- 1962494583
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 35046069 (OH)
- Practice address
- 301 Perry St
Fostoria, OH 44830-2149 - Phone
- (419) 435-9241
- NPI assigned
- Aug 19, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070124000286 | OH | Practitioner - Internal Medicine | 3375544000 |
Reassigns benefits to 1 organization Practice locations: Tiffin, OH; Fostoria, OH; Maumee, OH |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35046069 | OH | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health Physicians - North, LLC | Current |
Accepting new patients | |
| Mercy Health Physicians-North LLC | Internal Medicine | Current |
Accepting new patients |
| Mercy Health - Tiffin Hospital LLC | Internal Medicine | Current | Accepting new patients |
| Mercy Health - Tiffin Hospital LLC | Past | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
5901 Monclova Rd
Maumee, OH 43537
Phone (419) 893-5911
45 St Lawrence Dr
Tiffin, OH 44883
Phone (419) 448-1900
2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35046069 | OH | Yes |
Addresses
Primary practice location
301 Perry St
Fostoria, OH 44830-2149
Mailing address
301 Perry St
Fostoria, OH 44830-2149
Phone (419) 435-9241
Other providers in Fostoria, OH
- Ryan Kinn
- Amy Kirkpatrick
- Timothy Dean Kistler
- Taylor Marie Kneip
- Kristina Carol Knoll
- Susan Krupp
- Barbara Kuhn
- Lane Drug Co
- Alison Leblanc
- Richard John Lee
All providers in Fostoria, OH · Internal Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.