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ATHRI KODALI MD
NPI 1841040128
Student in an Organized Health Care Education/Training Program in Pueblo, CO

Active since March 27, 2024PECOS Enrolled
902 LAKEVIEW AVE, PUEBLO, CO 81004(719) 557-5855(719) 557-5097 Get Directions Write a Review

NPPES record last updated: May 2, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Athri Kodali Md NPPES

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

ATHRI KODALI MD (NPI 1841040128) is an individual student in an organized health care education/training program in Pueblo, Colorado, licensed in Colorado (PENDING) and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1841040128
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameATHRI KODALICredential: MD
Location Address902 LAKEVIEW AVEPueblo, CO 81004-3597
Mailing Address902 Lakeview AvePueblo, CO 81004-3597
Phone(719) 557-5855
Fax(719) 557-5097
Sole ProprietorNo
Enumeration DateMarch 27, 2024
Last NPPES UpdateMay 2, 2024
NPPES CertifiedMay 2, 2024
✔ NPI 1841040128 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in CO · PENDING
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.
Also ListedFamily MedicineTaxonomy 207Q00000X · License TL.0010278 (CO)
902 LAKEVIEW AVE, Pueblo, CO 81004
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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)

Athri Kodali Md 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. CAMILA TERESA ROBLES DO
Family Medicine
902 LAKEVIEW AVE
PUEBLO, CO 81004
Pueblo County (719) 557-5872
MARK DAVIS PA-C
Physician Assistant
902 LAKEVIEW AVE
PUEBLO, CO 81004
Pueblo County (719) 557-5855
MADISON BASSETT
Student in an Organized Health Care Education/Training Program
902 LAKEVIEW AVE
PUEBLO, CO 81004
Pueblo County (719) 557-5855
REBECKA ANN REATHERFORD AGACNP-BC
Nurse Practitioner (Acute Care)
902 LAKEVIEW AVE
PUEBLO, CO 81004
Pueblo County (719) 557-5855
LUCINEI GERALDO STADNIK MD
Student in an Organized Health Care Education/Training Program
902 LAKEVIEW AVE
PUEBLO, CO 81004
Pueblo County (719) 557-5872
DR. LISA HAMILTON MD
Student in an Organized Health Care Education/Training Program
902 LAKEVIEW AVE
PUEBLO, CO 81004
Pueblo County (719) 557-5872
TIFFANY ANNE GARCIA FNP
Nurse Practitioner (Family)
902 LAKEVIEW AVE
PUEBLO, CO 81004
Pueblo County (719) 557-5855
DR. KIMBERLEY EVELYN JACKSON D.O.
General Practice
902 LAKEVIEW AVE
PUEBLO, CO 81004
Pueblo County (719) 557-5855

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Athri Kodali's NPI number?

The NPI number for Athri Kodali is 1841040128. It was assigned to this individual provider in the NPPES registry on March 27, 2024.

Where is Athri Kodali located?

Athri Kodali practices at 902 Lakeview Ave, Pueblo, CO 81004. The listed phone number is (719) 557-5855.

What is Athri Kodali's specialty?

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

Is Athri Kodali enrolled in Medicare?

Yes. Athri Kodali is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Athri Kodali was last updated on May 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.