DR. SIVASANKARA R KONALA (NPI# 1538104229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538104229 |
| Entity Type | Individual |
| Full Name | DR. SIVASANKARA R KONALA |
| Other Name | DR. SIVA SANKARA R KONALA |
| Credential | MD |
| Practice Address |
1111 W Pearce Blvd Wentzville MO 63385-1020 |
| Mailing Address |
200 Corporate Blvd Lafayette LA 70508-3870 |
| Practice Telephone | 6368874288 |
| Practice Fax Number | 6366392368 |
| Mailing Telephone | 8008939698 |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2019-05-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 1083988 | MO | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | 108398 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 204888713 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 Medical Plz, Lake St Louis, MO 633671366 | 6366255200 | 6366255314 |
| Street Address |
1111 W PEARCE BLVD |
| City | WENTZVILLE |
| State | MO |
| Zip Code | 63385-1020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023000932 | Kathryn C Steinmann | Licensed Practical Nurse | 1111 W Pearce Blvd, Wentzville, MO 63385-1020 | 2005-08-17 |
| 1558765362 | Megan Elizabeth Gibbons | Nurse Practitioner | 1111 W Pearce Blvd, Wentzville, MO 63385-1020 | 2014-10-22 |
| 1073883146 | Elizabeth Johnson | Nurse Practitioner | 1111 W Pearce Blvd, Wentzville, MO 63385-1020 | 2012-01-06 |
| 1902815863 | Our Urgent Care, LLC | Clinic/Center | 1111 W Pearce Blvd, Wentzville, MO 63385-1020 | 2006-08-07 |
| 1619959137 | Kalugotla N Shivaram | Emergency Medicine | 1111 W Pearce Blvd, Wentzville, MO 63385-1020 | 2005-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730243 | Jeffery William Ellis | Pharmacist | 1571 Wentzville Parkway, Wentzville, MO 63385 | 2020-11-05 |
| 1487266011 | Jason Wade Moore | Peer Specialist | 5 West Pearce Boulevard, Wentzville, MO 63385 | 2020-08-17 |
| 1265906176 | Montrice M Haynes | Counselor | 500 Medical Dr., Central Intake, Wentzville, MO 63385 | 2019-01-14 |
| 1841718459 | Linda Duree | Counselor | 7105 Whisper Creek Dr, Wentzville, MO 63385 | 2017-09-03 |
| 1811349368 | Sara Kleinlein | Social Worker | 500 Medical Drive, Wentzville, MO 63385 | 2016-07-08 |
| 1275980757 | Teona Moeller | Nurse Practitioner | 1598 West Meyer Dr., Wentzville, MO 63385 | 2016-05-16 |
| 1831561273 | Jay F. Hauser, Dds, PC | Dentist | 11 Wentzville Bluffs Drive, Wentzville, MO 63385 | 2015-10-26 |
| 1720402035 | Shara Kuehl | Speech-Language Pathologist | One Campus Drive, Wentzville, MO 63385 | 2014-02-06 |
| 1336480474 | Simply Loyal In Home and Transport Services LLC | Home Health | 152 Enterprise Dr, Wentzille, MO 63385 | 2013-03-14 |
| 1750641338 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1849 Wentzville Parkway, Wentzville, MO 63385 | 2012-05-17 |
| Find all providers in zip 63385 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1992844252 | Heartland Internal Medicine | Internal Medicine | 1021 Wentzville Pkwy, Wentzville, MO 63385-3437 | 2007-02-05 |
| 1104913896 | Navin Choudhary | Internal Medicine | 105 Creekside Office Drive, Wentzville, MO 63385 | 2006-10-06 |
| 1174615025 | Ria Medical, LLC | Internal Medicine | 105 Creekside Office Dr., Wentzville, MO 63385 | 2006-09-29 |
| 1316910987 | Nighat S Qadri | Internal Medicine | 1032 Crosswinds Ct, Wentzville, MO 63385-4836 | 2006-02-13 |
| 1427476100 | John Paul Shoup | Internal Medicine | 801 Medical Dr Ste 400, Wentzville, MO 63385-3824 | 2014-03-31 |
| 1124306287 | Amanda Jewel Sileo | Internal Medicine | 1502 W Meyer Rd, Wentzville, MO 63385-3653 | 2011-07-23 |
| 1568698306 | Suraj Kumar Alakkassery Kumaran | Internal Medicine | 1032 Crosswinds Ct, Wentzville, MO 63385-4836 | 2009-06-08 |
| 1922295765 | Brooke Adams Colbert | Internal Medicine | 1603 Wentzville Pkwy, Wentzville, MO 63385-3826 | 2007-09-25 |
| 1588618755 | Ssm Health Care St. Louis | Internal Medicine | 500 Medical Dr, Wentzville, MO 63385-3421 | 2006-05-20 |
| 1053306977 | Lee H Turk | Internal Medicine | 500 Medical Dr, Wentzville, MO 63385-3421 | 2005-09-16 |
| Find all providers in WENTZVILLE | ||||
| City | WENTZVILLE |
| Zip Code | 63385 |
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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.