KRISHNAMRAJU KOSURU (NPI# 1013204296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013204296 |
| Entity Type | Individual |
| Full Name | KRISHNAMRAJU KOSURU |
| Credential | M.D |
| Practice Address |
3126 S Jackson Ave Suite 100 Joplin MO 64804-2534 |
| Mailing Address |
Po Box 504944 Saint Louis MO 63150-4944 |
| Practice Telephone | 4175563416 |
| Practice Fax Number | 4175563417 |
| Mailing Telephone | 4178294620 |
| Mailing Fax Number | 4178294316 |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2016-01-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 2015040888 | MO | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 0437804 | KS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1013204296 | 05 | |
| KS | PENDING | 05 | |
| OK | 200622340A | 05 |
| Street Address |
3126 S JACKSON AVE SUITE 100 |
| City | JOPLIN |
| State | MO |
| Zip Code | 64804-2534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851390645 | Paul Milton Olive | Orthopaedic Surgery | 3126 S Jackson Ave, Ste 200, Joplin, MO 64804-2534 | 2005-07-14 |
| 1922427640 | Donna J Schultz | Nurse Practitioner | 3126 S Jackson Ave, Ste 201, Joplin, MO 64804-2534 | 2014-04-09 |
| 1689090888 | Mercy Clinic Joplin LLC | Prosthetic/Orthotic Supplier | 3126 S Jackson Ave, Ste 200, Joplin, MO 64804-2534 | 2014-03-12 |
| 1720403009 | Monica M. Mckee | Physician Assistant | 3126 S Jackson Ave, Ste 101, Joplin, MO 64804-2534 | 2014-02-24 |
| 1225452873 | Rebecca C Moss | Nurse Practitioner | 3126 S Jackson Ave, Ste 101, Joplin, MO 64804-2534 | 2014-02-18 |
| 1366711616 | Anne Michelle Maxey | Family Medicine | 3126 S Jackson Ave, Joplin, MO 64804-2534 | 2011-12-15 |
| 1003103490 | Justin James Dillingham | Family Medicine | 3126 S Jackson Ave, Ste 101, Joplin, MO 64804-2534 | 2011-07-06 |
| 1194801324 | Dennis William Smith | Internal Medicine | 3126 S Jackson Ave, Ste 200, Joplin, MO 64804-2534 | 2006-10-31 |
| 1124136718 | Maria Fe Fiel Bruce | Family Medicine | 3126 S Jackson Ave, Suite 201, Joplin, MO 64804-2534 | 2006-08-25 |
| 1801902135 | Wendell Dale Rankin | Internal Medicine | 3126 S Jackson Ave, Ste 200, Joplin, MO 64804-2534 | 2006-08-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718903 | Lisa Jo Moore | Nurse Practitioner | 2623 S Main Street, Nixa, MO 64804 | 2020-10-22 |
| 1346859600 | Centered and Connected LLC | Counselor | 2401 E 32nd St, Ste 10 #103, Joplin, MO 64804 | 2020-07-23 |
| 1649838780 | Nicole Lynn Egan | Social Worker | 3010 Mcclelland, Joplin, MO 64804 | 2019-06-04 |
| 1902361652 | Redings Mill Internal Care | Clinic/Center | 454 Redings Mill Rd, Joplin, MO 64804 | 2019-02-06 |
| 1447732508 | Urgent Care Travel, Inc | Clinic/Center | 5931 E 32nd Street, Joplin, MO 64804 | 2018-09-05 |
| 1912488891 | Karl G. Keczkemethy | Dietitian, Registered | 100 Mercy Way Ste 570, Joplin, MO 64804 | 2018-08-28 |
| 1790207546 | Jacksie Short | Dentist | 2819 E 29th St, Joplin, MO 64804 | 2017-07-13 |
| 1326574625 | Kristine Kwon Rowland | Nurse Practitioner | 100 Mercy Way Ste 320-330, Joplin, MO 64804 | 2017-05-05 |
| 1942735212 | West R Loveland | Counselor | 3230 S Wisconsin St Suite H, Joplin, MO 64804 | 2017-04-25 |
| 1174070205 | Tracy L Fry | Nurse Practitioner | 3333 Mcintosh Cir Ste 4, Joplin, MO 64804 | 2016-09-07 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144669458 | Lindsey Mcclintick | Pediatrics | 3333 Mcintosh Cir Ste 1, Joplin, MO 64804-3681 | 2013-06-19 |
| 1649400375 | Dian Lea Doody | Pediatrics | 1 Emerald Way, Joplin, MO 64804-5060 | 2009-07-15 |
| 1528160660 | Kathryn Elizabeth Garrett | Pediatrics | 1030 Mcintosh Cir Ste 1, Joplin, MO 64804-3690 | 2006-09-01 |
| 1942235155 | Paul David Petry | Pediatrics | 3333 Mc Intosh Cir, Suite 1, Joplin, MO 64804-3649 | 2006-07-12 |
| 1770513210 | Raymond Grote | Pediatrics | 702 E 34th Street, Ste 203, Joplin, MO 64804 | 2006-07-03 |
| 1043249626 | Rayni L Teeter | Pediatrics | 3126 Wisconsin Ave, Joplin, MO 64804-2873 | 2006-07-03 |
| 1972539229 | Enrico G Esguerra | Pediatrics | 702 East 34th St., #103, Joplin, MO 64804 | 2006-06-25 |
| 1912943515 | Laura R Henness | Pediatrics | 1030 Mcintosh Cir, Ste 2, Joplin, MO 64804-3642 | 2006-06-21 |
| 1316207137 | Susan Annette Pitts | Pediatrics | 100 Mercy Way, Joplin, MO 64804 | 2012-05-26 |
| 1285994376 | Rahul Oberoi | Pediatrics | 1102 W 32nd St, Joplin, MO 64804 | 2012-05-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.