Healthcare Provider Details

I. General information

NPI: 1306770235
Provider Name (Legal Business Name): NAGA SRI ANILA DEVI PENEGALAPATI BPT, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NAGA SRI ANILA DEVI TUMMALA

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 NC 55 HWY STE 101
CARY NC
27519-8427
US

IV. Provider business mailing address

517 LAUREN ANN DR
APEX NC
27523-8530
US

V. Phone/Fax

Practice location:
  • Phone: 919-290-2799
  • Fax:
Mailing address:
  • Phone: 617-816-0055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP24864
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: