{"npi":"1629332218","type":"NPI-2","status":"active","name":{"display":"Vijaya Challa, M.D.P.C.","other":[],"organization_name":"VIJAYA CHALLA, M.D.P.C.","authorised_official":"Venky Challa"},"specialty":{"primary_taxonomy":"261QP2300X","primary_taxonomy_description":"Primary Care Clinic","slug":"primary-care-clinic","schema_org_specialty":"PrimaryCare","all":[{"code":"261QP2300X","description":"Primary Care Clinic","primary":true,"state":"MI","license":"VC080035"}]},"addresses":[{"purpose":"LOCATION","street_1":"24604 MICHIGAN AVE STE 100","city":"DEARBORN","state":"MI","postal_code":"481241760","country_code":"US","phone":"3135629020","fax":"3135628511"},{"purpose":"MAILING","street_1":"24604 MICHIGAN AVE STE 100","city":"DEARBORN","state":"MI","postal_code":"481241760","country_code":"US","phone":"3135629020","fax":"3135628511"}],"license":{"state":"MI","number":"VC080035"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"4865150","state":"MI","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20120914000715","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"MI","pac_id":"2264680396"}]},"enumeration_date":"2012-06-27","last_updated":"2026-06-08","_meta":{"source":"NPPES","snapshot_date":"2026-06-08","doc_url":"https://findmynpi.com/api"}}