Individual provider Active NPI

Ravi Prasad Sai Vemulapalli, MD

  • Gastroenterology Physician
  • Clive, IA
National Provider Identifier
1992763122
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
31960 Issued in IA
Practice address
1378 NW 124TH St
Suite 200
Clive, IA 50325-8151
Phone
(515) 288-6097
Fax
(515) 288-6099
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 31960 IA Primary

Addresses

Primary practice location

1378 NW 124TH St
Suite 200
Clive, IA 50325-8151

Mailing address

1378 NW 124TH St
Suite 200
Clive, IA 50325-8151
Phone (515) 288-6097

Other identifiers 1

IdentifierTypeStateIssuer
0171413MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20060417000124 IA Practitioner - Gastroenterology 2163439654 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31960IAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Endoscopy Center, Inc. CurrentSince Jul 1, 2014 Accepting new patients
Iowa Digestive Disease Center P.C. Gastroenterology CurrentSince Jul 15, 1998 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

1378 NW 124th St
Ste 100
Clive, IA 50325
Phone (515) 288-3342

1378 NW 124th St
Ste 200
Clive, IA 50325
Phone (515) 288-6097

Interoperability endpoints

  • Direct secure messaging: rvemulapalli3960272@direct.trinity-health.org

Organizations & group practices 3

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1992763122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1378 NW 124TH ST",
            "address_2": "SUITE 200",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258151",
            "telephone_number": "515-288-6097",
            "fax_number": "515-288-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1378 NW 124TH ST",
            "address_2": "SUITE 200",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258151",
            "telephone_number": "515-288-6097",
            "fax_number": "515-288-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEMULAPALLI",
        "first_name": "RAVI",
        "middle_name": "PRASAD SAI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IA",
            "license": "31960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0171413",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.