MR. CHANDRA B. DOMMARAJU (NPI# 1255361135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255361135 |
| Entity Type | Individual |
| Full Name | MR. CHANDRA B. DOMMARAJU |
| Credential | M.D. |
| Practice Address |
1400 Us Highway 61 240b Festus MO 63028-4141 |
| Practice Telephone | 6369332344 |
| Practice Fax Number | 6369379031 |
| Mailing Telephone | 6369332344 |
| Mailing Fax Number | 6369379031 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2013-12-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
106962 | MO | Allopathic & Osteopathic Physicians |
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
MO106962 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 205115322 | 05 |
| Street Address |
1400 US HIGHWAY 61 240B |
| City | FESTUS |
| State | MO |
| Zip Code | 63028-4141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264493 | Kaile Jean Eggemeyer | Nurse Practitioner | 1400 Us Highway 61, Festus, MO 63028-4100 | 2020-10-29 |
| 1073010419 | Amanda Rae Mcvey | Registered Nurse | 1400 Us Highway 61, Festus, MO 63028-4100 | 2018-04-11 |
| 1417482530 | Lauren Kerley | Nurse Anesthetist, Certified Registered | 1400 Us Highway 61, Festus, MO 63028-4100 | 2017-04-26 |
| 1669907242 | Mahmoud Mohamed Elfadil | Internal Medicine | 1400 Us Highway 61, Festus, MO 63028-4100 | 2017-04-20 |
| 1346797305 | John Westley Pipkin | Nurse Practitioner | 1400 Us Highway 61, Festus, MO 63028 | 2016-09-07 |
| 1427401579 | Gwendolyn Bailey | Social Worker | 1400 Us Highway 61, Festus, MO 63028-4100 | 2016-07-13 |
| 1710337274 | Matthew James Crisp | Internal Medicine | 1400 Us Highway 61, Festus, MO 63028-4100 | 2016-06-15 |
| 1417311242 | Anthony Sanders | Registered Nurse | 1400 Us Highway 61, Festus, MO 63028-4100 | 2016-04-07 |
| 1780079053 | Debbie Trudell | Counselor | 1400 Us Highway 61, Festus, MO 63028-4100 | 2015-04-02 |
| 1417349234 | Rouba Ghoussoub Md LLC | Internal Medicine | 1400 Us Highway 61, G30, Festus, MO 63028-4100 | 2015-03-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952943268 | Lauryn E Morris | Occupational Therapist | 3657 Baptist Park Rd, Mapaville, MO 63028 | 2019-10-09 |
| 1912557547 | Rena Robinson | Technician | 150 Brandon Wallace Way Suite 1014, Suite 1014, Festus, MO 63028 | 2019-09-16 |
| 1780232264 | Cynthia L James | Technician | 110 Juliet Place, Festus, MO 63028 | 2019-08-28 |
| 1700377009 | Akr Endodontics, LLC | Dentist | 1431 Us Hwy 61, Festus, MO 63028 | 2018-05-22 |
| 1962869990 | Fatma Esen Antakli | Nurse Practitioner | Advanced Pain Centers 190 Industrial Drive, Festus, MO 63028 | 2016-01-21 |
| 1083088744 | Megan Schomer | Counselor | 2675 Meyer Rd, Festus, MO 63028 | 2015-11-18 |
| 1043608144 | Elka Follmer | Physical Therapist | 1349 Us Hwy 61, Festus, MO 63028 | 2014-12-26 |
| 1811394729 | Ashley Schwendeman | Physical Therapist | 1403 N. Truman Blvd, Fesuts, MO 63028 | 2014-11-21 |
| 1073871257 | Staurla Chantel Waun | Counselor | 10719 Buckeye Rd, Festus, MO 63028 | 2012-04-25 |
| 1639444086 | Jeffrey Steitz | Otolaryngology | 1390 Us Highway 61 Ste 3100, Festus, MO 63028 | 2012-03-19 |
| Find all providers in zip 63028 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023113438 | Id Consultants, P.C. | Internal Medicine | 1400 Us Highway 61, 240b, Festus, MO 63028-4141 | 2006-09-13 |
| 1255361127 | Id Consultants, PC | Internal Medicine | 1390 Us Highway 61, Suite G1500, Festus, MO 63028-4137 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598242778 | Metro Infectious Disease Consultants, LLC | Internal Medicine | 2340 E Meyer Blvd Ste 348, Kansas City, MO 64132-1129 | 2018-07-20 |
| 1396284303 | Southwest Missouri Infectious Disease LLC | Internal Medicine | 2872 S Forrest Heights Ave, Springfield, MO 65809-3417 | 2017-02-23 |
| 1194125195 | West County Infectious Disease, LLC | Internal Medicine | 16918 Westridge Oaks Dr, Grover, MO 63040-1127 | 2014-08-26 |
| 1306188784 | Rachel T Weihe | Internal Medicine | 200 Ne 54th Street, Suite 111, Kansas City, MO 64118 | 2013-03-22 |
| 1588912448 | Idim | Internal Medicine | 1909 Larimer Trl, Wildwood, MO 63011-4801 | 2012-08-27 |
| 1548524218 | Blessy John | Internal Medicine | 2115 S Fremont Ave Ste 3050, Springfield, MO 65804-2236 | 2012-06-27 |
| 1346532769 | Malcolm Koldin | Internal Medicine | 13 Autumn Shores Ct, Maryland Heights, MO 63043-4913 | 2011-05-03 |
| 1528246071 | Rajashree Gottimukkula | Internal Medicine | 3691 Rutger St Ste 100, Drummond Hall, Saint Louis, MO 63110-2515 | 2008-02-07 |
| 1497943393 | West County Adult Medicine, LLC | Internal Medicine | 224 S Woods Mill Rd Ste 510s, Chesterfield, MO 63017-3611 | 2007-10-05 |
| 1881885044 | Getahun Abate | Internal Medicine | 1100 S. Grand Blvd., Drc-8th Floor, Saint Louis, MO 63104-3325 | 2007-08-05 |
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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.