Individual provider Active NPI

Chitra R Uppaluri, MD

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1992758825
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2000158940 Issued in MO
Practice address
6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone
(314) 768-8000
Fax
(314) 768-8011
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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 2000158940 MO Primary

Addresses

Primary practice location

6420 Clayton Rd
Saint Louis, MO 63117-1811

Mailing address

1836 Lackland Hill Pkwy
Attnt: Credentialing Dept
Saint Louis, MO 63146-3572
Phone (314) 989-0300

Other identifiers 1

IdentifierTypeStateIssuer
205368707MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20100922000035 MO Practitioner - Internal Medicine 3072639590 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2000158940MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St Louis CurrentSince Jan 1, 2016 Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

8820 Manchester Rd
Saint Louis, MO 63144
Phone (314) 963-8100

Organizations & group practices 1

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1992758825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 LACKLAND HILL PKWY",
            "address_2": "ATTNT: CREDENTIALING DEPT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463572",
            "telephone_number": "314-989-0300",
            "fax_number": "314-810-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171811",
            "telephone_number": "314-768-8000",
            "fax_number": "314-768-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPPALURI",
        "first_name": "CHITRA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2000158940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205368707",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.