Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Vanitha Banajjar Revanasiddappa, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1669856217

Dr. Vanitha Banajjar Revanasiddappa, MD is an Obstetrics/Gynecology in Charlotte, North Carolina. Qualified in 2012, 14 years ago. Practices with Novant Health Medical Group, LLC, a 2,410-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California and North Carolina.

Years since qualifying
14
Licensed in
CA, NC
In the registry since
2015
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1718 E 4th St Ste 907
Charlotte, NC 28204-3282
Phone: (704) 372-4000
Fax: (704) 334-4855
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 797 W Childs Ave, Merced, CA 95341-6805 — (866) 682-4842
  • 1650 Grand Concourse, Bronx, NY 10457-7606 — (718) 579-3992

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 2025-01298 (NC)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence A162179 (CA)

Record details

NPI number1669856217
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 14, 2015
Last updated in NPPESOctober 28, 2025
Certification dateOctober 28, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Novant Health Medical Group, Llc — 2410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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