Individual provider Active NPI

Govardhana Roa Korrapati, M.D.

  • Internal Medicine Physician
  • Fostoria, OH
National Provider Identifier
1962494583
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35046069 Issued in OH
Practice address
301 Perry St
Fostoria, OH 44830-2149
Phone
(419) 435-9241
NPI assigned
Aug 19, 2005
Last updated
Feb 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35046069 OH Primary

Addresses

Primary practice location

301 Perry St
Fostoria, OH 44830-2149

Mailing address

301 Perry St
Fostoria, OH 44830-2149
Phone (419) 435-9241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20070124000286 OH Practitioner - Internal Medicine 3375544000 Reassigns benefits to 1 organization
Practice locations: Tiffin, OH; Fostoria, OH; Maumee, OH

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35046069OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health - Tiffin Hospital LLC Internal Medicine Current Accepting new patients
Mercy Health Physicians-North LLC Internal Medicine CurrentSince Mar 11, 2017 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Mar 11, 2017 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

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1962494583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PERRY ST",
            "city": "FOSTORIA",
            "state": "OH",
            "postal_code": "448302149",
            "telephone_number": "419-435-9241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PERRY ST",
            "city": "FOSTORIA",
            "state": "OH",
            "postal_code": "448302149",
            "telephone_number": "419-435-9241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORRAPATI",
        "first_name": "GOVARDHANA",
        "middle_name": "ROA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35046069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fostoria, OH

Sources for this page

Verify at the official NPI Registry.