LINGAREDDY DEVIREDDY MD PC (NPI# 1194115402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1194115402 |
Entity Type | Organization |
Organization Name | LINGAREDDY DEVIREDDY MD PC |
Practice Address |
11900 E 12 Mile Rd Suite 103 Warren MI 48093-3400 |
Practice Telephone | 5865740890 |
Practice Fax Number | 5865749321 |
Mailing Telephone | 5865740890 |
Mailing Fax Number | 5865749321 |
Enumeration Date | 2015-01-26 |
Last Update Date | 2015-01-26 |
Authorized Official Name | SRINIVAS KONERU (MD) |
Authorized Official Telephone | 5865740890 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
4301080674 | MI | Ambulatory Health Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225082654 | Lingareddy Devireddy Md PC | Internal Medicine | 11900 E 12 Mile Rd, Suite 103, Warren, MI 48093-3487 | 2006-05-20 |
Street Address |
11900 E 12 MILE RD SUITE 103 |
City | WARREN |
State | MI |
Zip Code | 48093-3400 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194720276 | Stuart R Gildenberg | Dermatology | 11900 E 12 Mile Rd, Ste 201, Warren, MI 48093-3490 | 2005-06-16 |
1902459159 | Tammy Jean Cass | Registered Nurse | 11900 E 12 Mile Rd, Warren, MI 48093-3400 | 2019-07-17 |
1437715026 | Dalia Hasso | Student in an Organized Health Care Education/Training Program | 11900 E 12 Mile Rd, Warren, MI 48093-3400 | 2019-05-19 |
1174070577 | Hayley Foster | Physician Assistant | 11900 E 12 Mile Rd, Suite 110, Warren, MI 48093-3400 | 2016-09-02 |
1063872877 | Andrew Cox | Physician Assistant | 11900 E 12 Mile Rd, Suite 110, Warren, MI 48093-3400 | 2016-03-07 |
1538561469 | Erica Williams | Physician Assistant | 11900 E 12 Mile Rd, Suite 110, Warren, MI 48093-3400 | 2014-09-23 |
1578994737 | Mendelson Orthopedics | Orthopaedic Surgery | 11900 E 12 Mile Rd, Suite 105, Warren, MI 48093-3400 | 2013-12-12 |
1548542020 | Brittany J Miller | Physician Assistant | 11900 E 12 Mile Rd, Suite 100, Warren, MI 48093-3400 | 2011-09-12 |
1285916825 | Theresa Jeanette Richardson | Physician Assistant | 11900 E 12 Mile Rd, Suite 100, Warren, MI 48093-3400 | 2011-09-09 |
1649562307 | Daniel Feldman | Anesthesiology | 11900 E 12 Mile Rd, Suite 110, Warren, MI 48093-3400 | 2011-05-12 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023615986 | Toleka Regina Taylor | Nurse Anesthetist, Certified Registered | St. John Macomb Hospital, 11800 East 12 Mile Road, Warren, MI 48093 | 2020-10-05 |
1679112676 | Open Heart Communities | Case Management | 31310 Shaw Dr, Warren, MI 48093 | 2019-12-23 |
1538715636 | 3 Dove Medical Supplies | Durable Medical Equipment & Medical Supplies | 31201 Chicago Rd S Ste C101, Warren, MI 48093 | 2019-08-14 |
1568954600 | Schreiber Cardiology, P.C. | Internal Medicine | 8545 Common Rd Ste 150, Warren, MI 48093 | 2018-06-05 |
1730686197 | Lambro Seremetis | Social Worker | 12200 E. 12 Mile Road, Ste. 200, Warren, MI 48093 | 2018-04-11 |
1649775826 | Ridge Downs | Behavioral Analyst | 31201 Chicago Rd South, Suite C- 202, Warren, MI 48093 | 2018-03-28 |
1144722737 | Jessica Farraj | Occupational Therapist | 11800 E. 12 Mile Road, Warren, MI 48093 | 2018-02-28 |
1265930168 | Leah Hanrahan | Registered Nurse | 11700 Amberle Dr., Warren, MI 48093 | 2018-01-25 |
1598271553 | Pamela Marie Confer | Occupational Therapist | 11012 13 Mile Rd, Suite 200, Warren, MI 48093 | 2017-12-28 |
1831604347 | Kate Jeanne Szczepanski | Behavior Technician | 31200 Chicago Rd S, Warren, MI 48093 | 2017-12-06 |
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Taxonomy Code | 261QM2500X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Medical Specialty |
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
Notes: [7/1/2003: new] |
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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.