DR. PRAVEENA GORANTLA M.D NPI 1114107182

NPI Information

  • NPI: 1114107182
  • Provider Name: DR. PRAVEENA GORANTLA, M.D
  • Classification: Internal Medicine - 207RR0500X
  • Specialization: Rheumatology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1921 N WEBB RD
    WICHITA, KS
    ZIP 67206
  • Phone: (316) 612-4815

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NPI Details

DR. Praveena Gorantla, M.D is a rheumatology internal medicine in Wichita, KS with 27 years of experience. The provider is an internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases. DR. Praveena Gorantla, M.D NPI is 1114107182. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1921 N WEBB RD
WICHITA, KS
ZIP 67206-405
Phone: (316) 612-4815
Fax: (316) 612-4825

The NPI 1114107182 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 11/7/2007 and was last updated on 8/16/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RR0500XInternal MedicineRheumatology04-33130KANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200569320AMEDICAIDKANSAS
2P01144793OTHERRR MEDICARE

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: 11/21/2025

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