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

Individual provider Nephrology Physician · NPI 1255645446

Pradeep Kumar Vaitla, MD is a Nephrology in Jackson, Mississippi. Qualified in 2007, 19 years ago. Practices with State of Mississippi - University of Mississippi Medical Center, a 952-clinician group and accepts Medicare assignment. Licensed in Louisiana and Mississippi.

Years since qualifying
19
Licensed in
LA, MS
In the registry since
2010
Specialties on file
2
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

2500 N State St
Jackson, MS 39216-4500
Phone: (601) 984-5065
Fax: (601) 984-2962
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence 24433 (MS)
Nephrology Physician Taxonomy 207RN0300X · Licence MD.206335 (LA)

Record details

NPI number1255645446
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 30, 2010
Last updated in NPPESJuly 2, 2019
Mailing address2500 North State Street, Jackson, MS 39216-4500

Medicare enrollment

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

Medicare specialtyNEPHROLOGY
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice State Of Mississippi - University Of Mississippi Medical Center — 952 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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