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PRADEEP KUMAR VAITLA MD NPI 1255645446


NPI Information

NPI: 1255645446
Provider Name: PRADEEP KUMAR VAITLA, MD
Classification: Internal Medicine - 207RN0300X
Entity Type: Individual

Specialization: Nephrology

PECOS Registration: Yes

Address:
2500 NORTH STATE STREET
JACKSON, MS
ZIP 39216
Phone: (601) 984-5065
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Pradeep Kumar Vaitla, MD is a nephrology internal medicine in Jackson, MS with 17 years of experience. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. Pradeep Kumar Vaitla, MD NPI is 1255645446. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2500 NORTH STATE STREET
JACKSON, MS
ZIP 39216-500
Phone: (601) 984-5065
Fax: (601) 984-2962

The NPI 1255645446 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/30/2010 and was last updated on 7/2/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RN0300XInternal MedicineNephrologyMD.206335LOUISIANANo
2207RN0300XInternal MedicineNephrology24433MISSISSIPPIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.