Kedarnath Krishnamurthy Challakere, MD

Key facts

NPI

1972610335

Entity type

Individual (NPI type 1)

Primary specialty

Psychiatry Physician 2084P0800X

License

A45337 (CA)

Practice address

400 N Pepper Ave
Colton, CA 92324-1801

Phone

(415) 305-7019

Fax

(415) 366-2025

NPI assigned

Aug 23, 2006

Sex

Male

Sole proprietor

Yes

Organizations & group practices 12

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.

• Alliance for Wellness, Inc. Psychiatry Physician · Inglewood, CA · NPI 1124329131
  Medicare reassignment NPD CA · PSYCHIATRY
• Cep America - Psychiatry PC Psychiatry Physician · Santa Maria, CA · NPI 1538757232
  Medicare reassignment NPD CA · PSYCHIATRY
• County of San Bernardino Mental Health Clinic/Center (Including Community Mental Health Center) · San Bernardino, CA · NPI 1164467023
  Medicare reassignment NPD CA
• County of San Diego Public Health or Welfare Agency · San Diego, CA · NPI 1225255375
  Medicare reassignment NPD CA
• Cep America - Psychiatry PC Psychiatry Physician · Indio, CA · NPI 1144195926
  NPD PSYCHIATRY
• Cep America - Psychiatry PC Psychiatry Physician · Colton, CA · NPI 1306408000
  NPD PSYCHIATRY
• County of San Bernardino General Acute Care Hospital · Colton, CA · NPI 1114091576
  NPD
• County of San Bernardino Mental Health Clinic/Center (Including Community Mental Health Center) · Apple Valley, CA · NPI 1346950904
  NPD
• County of San Diego Ambulance · San Diego, CA · NPI 1316685159
  NPD
• County of San Diego Community/Behavioral Health Agency · San Diego, CA · NPI 1386704351
  NPD
• Tamika Henry MD Inc Family Medicine Physician · Glendale, CA · NPI 1770381436
  NPD (past)
• Tri-City Mental Health Center Case Management Agency · Pomona, CA · NPI 1255651501
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 17, 2020.

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1972610335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60504",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943060504",
            "telephone_number": "415-305-7019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "415-305-7019",
            "fax_number": "415-366-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHALLAKERE",
        "first_name": "KEDARNATH",
        "middle_name": "KRISHNAMURTHY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "CA",
            "license": "A45337",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A45337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A453370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

• Vallerie Chacon
• Chul H Chae, M.D.
• Jessica Chaffin
• Saowarat S Chai, MD
• Meg Chakerian, DO
• Elizabeth Elna Chambers, MSW
• Jairo Chamorro
• Raymond Chan, M.D.
• Sophia Chan, M.D.
• Luis Miguel Chaname, D.O.

All providers in Colton, CA · Psychiatry Physician in California