Healthcare Provider Details

I. General information

NPI: 1144965252
Provider Name (Legal Business Name): ANANYA REDDY CINGIREDDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date: 02/10/2023
Reactivation Date: 05/03/2023

III. Provider practice location address

4351 E. LOHMAN AVE, MOUNTAIN VIEW REGIONAL MEDICAL CE SUITE 300
LAS CRUCES NM
88011
US

IV. Provider business mailing address

4351 E. LOHMAN AVE, MOUNTAIN VIEW REGIONAL MEDICAL CE SUITE 300
LAS CRUCES NM
88011
US

V. Phone/Fax

Practice location:
  • Phone: 575-556-7600
  • Fax:
Mailing address:
  • Phone: 575-556-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2025-01040
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: