1376515643 NPI number — KRISHNAMOORTHY BAIKADY RAO M.D

Table of content: KRISHNAMOORTHY BAIKADY RAO M.D (NPI 1376515643)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376515643 NPI number — KRISHNAMOORTHY BAIKADY RAO M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAO
Provider First Name:
KRISHNAMOORTHY
Provider Middle Name:
BAIKADY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376515643
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
585-597 MERRIMACK ST
Provider Second Line Business Mailing Address:
LOWELL COMMUNITY HEALTH CENTER
Provider Business Mailing Address City Name:
LOWELL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01854
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-746-7778
Provider Business Mailing Address Fax Number:
978-970-0359

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
585 MERRIMACK ST
Provider Second Line Business Practice Location Address:
LOWELL COMMUNITY HEALTH CENTER
Provider Business Practice Location Address City Name:
LOWELL
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01854
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-746-7778
Provider Business Practice Location Address Fax Number:
978-970-0359
Provider Enumeration Date:
02/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  216072 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RG0300X , with the licence number: 216072 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 59845 . This is a "FALLON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 973042 . This is a "NETWORK HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0408633 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7846502 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: A1440 . This is a "HARVARD PILGRIM HEALTHCAR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1305557 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3320315 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0029032 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042881348 . This is a "CHOICECARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: J26210 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042881348 . This is a "BEECH STREET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 468563 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042881348 . This is a "ONE HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042881348 . This is a "UNICARE" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com