DR. VANITHA BANAJJAR REVANASIDDAPPA MD NPI 1669856217

NPI Information

  • NPI: 1669856217
  • Provider Name: DR. VANITHA BANAJJAR REVANASIDDAPPA, MD
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1718 E 4TH ST STE 907
    CHARLOTTE, NC
    ZIP 28204
  • Phone: (704) 372-4000

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NPI Details

DR. Vanitha Banajjar Revanasiddappa, MD is an obstetrics gynecology in Charlotte, NC with 14 years of experience. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. DR. Vanitha Banajjar Revanasiddappa, MD NPI is 1669856217. 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:

1718 E 4TH ST STE 907
CHARLOTTE, NC
ZIP 28204-282
Phone: (704) 372-4000
Fax: (704) 334-4855

The NPI 1669856217 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 7/14/2015 and was last updated on 10/28/2025.

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
1207V00000XObstetrics & Gynecology2025-01298NORTH CAROLINAYes
2390200000XStudent in an Organized Health Care Education/Training ProgramNo
3207V00000XObstetrics & GynecologyA162179CALIFORNIANo

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
11669856217MEDICAIDCALIFORNIA

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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