PAVANA NAGA GOPI KRISHNA TIRUMANISETTI (NPI# 1083920086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083920086 |
| Entity Type | Individual |
| Full Name | PAVANA NAGA GOPI KRISHNA TIRUMANISETTI |
| Credential | MD |
| Practice Address |
1601 W 40th Ave Pine Bluff AR 71603-6069 |
| Mailing Address |
4021 W 8th St Little Rock AR 72204-2029 |
| Practice Telephone | 8705416000 |
| Practice Fax Number | 8705416009 |
| Mailing Telephone | 5016865021 |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2020-09-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | E-13165 | AR | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 206188 | LA | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 206188 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2118013 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2408 Broadmoor Blvd, Suite 2, Monroe, LA 712012963 | 3188070525 | 3188071077 |
| 309 Jackson St, Monroe, LA 712017407 | 3189664541 | 3189664543 |
| Street Address |
1601 W 40TH AVE |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71603-6069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629078266 | James Clyde Campbell | Internal Medicine | 1601 W 40th Ave, Suite 301, Pine Bluff, AR 71603-6319 | 2005-07-26 |
| 1447579073 | Nerie A Jamison | Family Medicine | 1601 W 40th Ave, Pine Bluff, AR 71603-6069 | 2010-05-21 |
| 1619139672 | Khalid Mohammad | Internal Medicine | 1601 W 40th Ave, Suite 301, Pine Bluff, AR 71603-6319 | 2008-06-30 |
| 1992994396 | Ricki Yvonne Fram | Internal Medicine | 1601 W 40th Ave, Suite 301, Pine Bluff, AR 71603-6319 | 2007-10-22 |
| 1629292883 | Nicholas Willis | Internal Medicine | 1601 W 40th Ave, Suite 301, Pine Bluff, AR 71603-6319 | 2007-04-12 |
| 1972547933 | Malcolm Brinkley Pearce | Specialist | 1601 W 40th Ave, Suite 301, Pine Bluff, AR 71603-6319 | 2006-06-16 |
| 1164463253 | Jefferson Heart, P.a. | Specialist | 1601 W 40th Ave, Suite 301, Pine Bluff, AR 71603-6319 | 2006-06-09 |
| 1932157674 | Jefferson Hospital Association, Inc | Anesthesiology | 1601 W 40th Ave, Suite 301, Pine Bluff, AR 71603-6319 | 2006-05-05 |
| 1295799443 | Ayman Alshami | Specialist | 1601 W 40th Ave, Suite 301, Pine Bluff, AR 71603-6319 | 2006-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445038 | Hannah Carter | Dentist | 3801 S Olive St, Pine Bluff, AR 71603 | 2019-06-11 |
| 1821544628 | Nauman Yunus Md Pa | Internal Medicine | 1600 West 40th Ave, Jefferson Regional Medical Center, Pine Bluff, AR 71603 | 2016-08-31 |
| 1407278120 | Arkansas Cancer Clinic Pa | Radiology | 7200 South Hazel Street, Pine Bluff, AR 71603 | 2014-01-15 |
| 1730515396 | Sharon Yvette Webb | Student in an Organized Health Care Education/Training Program | 2318 Kyle Street, Pine Bluff, AR 71603 | 2013-09-16 |
| 1477992733 | David Larry Byrd | Pharmacist | 5 Longmeadow, Pine Bluff, AR 71603 | 2013-06-20 |
| 1437400371 | Thomas Jordan Harper | Pharmacist | 2809 South Camden Road, Pine Bluff, AR 71603 | 2012-10-01 |
| 1992080469 | C&d Disability.inc | Early Intervention Provider Agency | 4806 W 9th Street, Pine Bluff, AR 71603 | 2011-10-17 |
| 1457645863 | Clifton G Roaf & Marvin Q Caudle | Dentist | 1310 South Linden Street, Pine Bluff, AR 71603 | 2011-06-02 |
| 1932402682 | Mary Campbell | Licensed Practical Nurse | 2302 W. 28th, Suite A, Pine Bluff, AR 71603 | 2010-12-17 |
| 1245468925 | Evan N Newbolt | Ophthalmology | 3805 West 28th Ave, Pine Bluff, AR 71603 | 2009-07-01 |
| Find all providers in zip 71603 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376001172 | Larisa Kachowski, Md | Family Medicine | 1726 W 42d Ave, Pine Bluff, AR 71603-7160 | 2019-03-11 |
| 1922578327 | Jefferson Hospital Association, Inc. | Family Medicine | 1801 W 40th Ave Ste 6a, Pine Bluff, AR 71603-6963 | 2018-11-28 |
| 1689191108 | Chizoba Usuwa | Family Medicine | 1601 W 40th Ave Ste 1, Pine Bluff, AR 71603-6069 | 2017-08-25 |
| 1649700337 | Raquel M Rivera-cruz | Family Medicine | 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6069 | 2017-06-14 |
| 1306156476 | Michele A Pashkevich Md Pa | Family Medicine | 1708 W 42nd Ave, Pine Bluff, AR 71603-7008 | 2010-10-07 |
| 1578881488 | Jaron Fredrick Byrd | Family Medicine | 6401 S Hazel St Apt 515, Pine Bluff, AR 71603-7848 | 2010-05-17 |
| 1023214574 | Larisa Kachowski | Family Medicine | 1726 W42d Ave, Pine Bluff, AR 71603 | 2007-06-22 |
| 1740217132 | James A Lindsey | Family Medicine | 1222 W 42nd Ave, Pine Bluff, AR 71603-7109 | 2006-06-28 |
| 1396772398 | Gerald Clifton Morris | Family Medicine | 209 N Blake St, Pine Bluff, AR 71601-3226 | 2006-06-26 |
| 1275569758 | University of Arkansas for Medical Sciences | Family Medicine | 1222 W 42nd St, Pine Bluff, AR 71603 | 2006-06-25 |
| Find all providers in PINE BLUFF | ||||
| City | PINE BLUFF |
| Zip Code | 71603 |
Please comment or provide details below to improve the information on PAVANA NAGA GOPI KRISHNA TIRUMANISETTI.
| 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.