JYOTHI PRAVALLIKA EDUPUGANTI DO
NPI 1205638723
Student in an Organized Health Care Education/Training Program in Cornelius, NC

Q: What is Jyothi Pravallika Edupuganti's NPI number?

The NPI number for Jyothi Pravallika Edupuganti is 1205638723. It was assigned to this individual provider in the NPPES registry on March 25, 2025.

Q: What is Jyothi Pravallika Edupuganti's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 25, 2025PECOS Enrolled

19485 OLD JETTON RD STE 100, CORNELIUS, NC 28031(704) 316-5170 Get Directions Write a Review

NPPES record last updated: June 16, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 16, 2025, Mar 27, 2025 (2 updates tracked since 2025).

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About Jyothi Pravallika Edupuganti Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JYOTHI PRAVALLIKA EDUPUGANTI DO (NPI 1205638723) is an individual student in an organized health care education/training program in Cornelius, North Carolina, licensed in North Carolina (RTL25-1107) and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205638723

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameJYOTHI PRAVALLIKA EDUPUGANTICredential: DO

Location Address19485 OLD JETTON RD STE 100Cornelius, NC 28031-6583

Mailing AddressPo Box 60447Charlotte, NC 28260-0447

Phone(704) 316-5170

Sole ProprietorYes

Enumeration DateMarch 25, 2025

Last NPPES UpdateJune 16, 20252 updates tracked since enumeration

NPPES CertifiedJune 16, 2025

✔ NPI 1205638723 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in NC · RTL25-1107

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

19485 OLD JETTON RD STE 100, Cornelius, NC 28031

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jyothi Pravallika Edupuganti Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GERARDO PEREZ DO

Student in an Organized Health Care Education/Training Program