Amarillo Colon and Rectal Clinic PA

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

Legal business name

AMARILLO COLON AND RECTAL CLINIC PA

Practice address

800 Quail Creek Drive
Suite 103
Amarillo, TX 79124-1634

Phone

(806) 358-7911

Fax

(806) 358-9600

NPI assigned

Jul 31, 2006

Organization subpart

No

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

Authorized official

Name

Sambasiva Rao Marupudi, MDNPI 1629007414

Title

President

Phone

(806) 358-7911

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sambasiva Rao Marupudi, MD

  • Colon & Rectal Surgery Physician
  • Amarillo, TX
  • NPI 1629007414
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992711329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 QUAIL CREEK DRIVE",
            "address_2": "SUITE 103",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791241634",
            "telephone_number": "806-358-7911",
            "fax_number": "806-358-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 QUAIL CREEK DRIVE",
            "address_2": "SUITE 103",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791241634",
            "telephone_number": "806-358-7911",
            "fax_number": "806-358-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMARILLO COLON AND RECTAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARUPUDI",
        "authorized_official_first_name": "SAMBASIVA",
        "authorized_official_middle_name": "RAO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "806-358-7911",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB7392",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INS CO",
            "identifier": "7330374",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "007KZ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Colon & Rectal Surgery Physician in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Colon & Rectal Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.