MR. VETTAIKORUMAKANKAV V VEDANARAYANAN (NPI# 1174565469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174565469 |
| Entity Type | Individual |
| Full Name | MR. VETTAIKORUMAKANKAV V VEDANARAYANAN |
| Credential | M.D. |
| Practice Address |
401 Baptist Dr Ste 301 Madison MS 39110-2012 |
| Mailing Address |
7731 Old Canton Rd Ste B Madison MS 39110-6115 |
| Practice Telephone | 6019845210 |
| Practice Fax Number | 6014990936 |
| Mailing Telephone | 6014990935 |
| Mailing Fax Number | 6014990936 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2019-05-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
12953 | MS | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 12953 | MS | Allopathic & Osteopathic Physicians |
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
12953 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00019355 | 05 | |
| AL | 155977 | 05 | |
| MS | RR MEDICARE | PTAN P00462340 | 01 |
| LA | 1982156 | 05 | |
| MS | RAILROAD MEDICARE PTAN | P01234014 | 01 |
| Street Address |
401 BAPTIST DR STE 301 |
| City | MADISON |
| State | MS |
| Zip Code | 39110-2012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255984472 | Callie Trice | Dietitian, Registered | 401 Baptist Dr Ste 301, Madison, MS 39110-2012 | 2019-07-17 |
| 1356836118 | Ochsner Mississippi, LLC | Internal Medicine | 401 Baptist Dr Ste 301, Madison, MS 39110-2012 | 2018-06-25 |
| 1417269275 | Whitney Herring | Pediatrics | 401 Baptist Dr Ste 301, Madison, MS 39110-2012 | 2010-07-09 |
| 1679740906 | Nina T Washington | Pediatrics | 401 Baptist Dr Ste 301, Madison, MS 39110-2012 | 2008-05-15 |
| 1659549681 | Michael C Mattingly | Pediatrics | 401 Baptist Dr Ste 301, Madison, MS 39110-2012 | 2008-02-12 |
| 1861600595 | Cynthia Bean | Obstetrics & Gynecology | 401 Baptist Dr Ste 301, Madison, MS 39110-2012 | 2007-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134784689 | Therapy South - Gluckstadt LLC | Physical Therapist | 1716 Us 51, Ste N, Madison, MS 39110 | 2019-05-09 |
| 1871054098 | Summit Medical Solutions | Durable Medical Equipment & Medical Supplies | 107 Azalea Street, Madison, MS 39110 | 2019-03-29 |
| 1912488198 | Madison Medical Compounding Pharmacy | Pharmacy | 111 Fountains Blvd. Building B Ste. A, Madison, MS 39110 | 2018-08-24 |
| 1679061469 | Nuvena Vein Clinic | Anesthesiology | 120 Fountains Blvd, Madison, MS 39110 | 2018-04-26 |
| 1467960484 | Brick City Drugs, LLC | Durable Medical Equipment & Medical Supplies | 159 Fountains Blvd, Madison, MS 39110 | 2018-01-11 |
| 1093227589 | Hannah Monk Hawthorne | Counselor | 930 Ebenezer Blvd., Suite D, Madisin, MS 39110 | 2017-10-25 |
| 1548786650 | Kimberly Allen | Pharmacist | 1100 Us- 51, Madison, MS 39110 | 2017-08-21 |
| 1891218186 | Delta Elizabeth Stark | Chiropractor | 1085 Gluckstadt Rd., Bld 300 Ste E, Madison, MS 39110 | 2017-07-19 |
| 1861914848 | Laura Hartlein | Dietitian, Registered | 200 Park Circle Dr. #2, Flowood, MS 39110 | 2017-07-12 |
| 1831620608 | Ona Irby | Occupational Therapist | 105 Munich Dr, Madison, MS 39110 | 2017-03-23 |
| Find all providers in zip 39110 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033521513 | Varun Sreenivasan | Psychiatry & Neurology | 7730 Old Canton Rd Bldg A, Madison, MS 39110-9299 | 2014-06-02 |
| 1063592301 | Sergio Facchini | Psychiatry & Neurology | 600 Highland Ave, Madison, WI 53792-0001 | 2006-10-17 |
| 1407895428 | Mary K Dominski | Psychiatry & Neurology | 700 S Park St, Madison, WI 53715-1830 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386147874 | Richard John Gorman Md | Psychiatry & Neurology | 1903 Pass Rd Ste A, Biloxi, MS 39531-4103 | 2018-03-12 |
| 1417213836 | Ashley Nicole Stanley-copeland | Psychiatry & Neurology | 2500 N State St, Jackson, MS 39216-4500 | 2012-04-10 |
| 1003006206 | Lamar Davis II | Psychiatry & Neurology | 2500 N State St, Jackson, MS 39216 | 2007-07-25 |
| 1972720175 | Anderson Regional Medical Center | Psychiatry & Neurology | 2124 14th St, Meridian, MS 39301 | 2007-04-19 |
| 1366562431 | Richard John Gorman | Psychiatry & Neurology | 1903 Pass Rd Ste A, Biloxi, MS 39531-4103 | 2007-03-30 |
| 1609929470 | Upa Pllc Neurology | Psychiatry & Neurology | 2500 N State St, Jackson, MS 39216-4500 | 2007-01-18 |
Please comment or provide details below to improve the information on MR. VETTAIKORUMAKANKAV V VEDANARAYANAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.