DR. SHYAM KIRAN GANDAM VENKATA (NPI# 1629332754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629332754 |
| Entity Type | Individual |
| Full Name | DR. SHYAM KIRAN GANDAM VENKATA |
| Credential | MD |
| Practice Address |
701 N 1st St Springfield IL 62781-2604 |
| Mailing Address |
1025 S 6th St Springfield IL 62703-2403 |
| Practice Telephone | 2175287541 |
| Mailing Telephone | 2175287541 |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2020-05-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
036143316 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 600 E 233rd St, Montefiore Medical Center Wakefield Campus, Bronx, NY 104662604 | 7189209880 |
| Street Address |
701 N 1ST ST |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62781-2604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982607123 | Memorial Home Services | Home Health | 701 N 1st St, Springfield, IL 62781-4952 | 2005-05-23 |
| 1316552524 | Mary Ann Seagle | Nurse Practitioner | 701 N 1st St, Springfield, IL 62781-0001 | 2020-09-14 |
| 1497372361 | Amir Mcphearson | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-26 |
| 1508482597 | Kirsten Kay Carew | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-25 |
| 1699391482 | Aruya Davis | Registered Nurse | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-17 |
| 1497370852 | Alyssa Rose Jimerson | Nurse Anesthetist, Certified Registered | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-11 |
| 1649895038 | Elisha Boyd | Nurse Practitioner | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-10 |
| 1275158990 | Ashley L Mcgrath | Nurse Anesthetist, Certified Registered | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-09 |
| 1205451812 | Christopher Evan Bejcek | Orthopaedic Surgery | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-09 |
| 1912521790 | Neil Carter Parker | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104145747 | Justin Neil Henry | Hospitalist | 701 N 1st St Rm B146, Springfield, IL 62781 | 2010-05-21 |
| 1457464208 | Edward J Ryan Poje | Pathology | 701 N First St, Memorial Medical Center, Springfield, IL 62781 | 2006-08-16 |
| 1649285453 | Sanjai Nagendra | Pathology | 701 N First Street, Springfield, IL 62781 | 2006-07-30 |
| 1770518706 | Daniel L Stanton Jr. | Radiology | 701 N. First St, Springfield, IL 62781 | 2006-07-11 |
| 1497914741 | Ted Robert Clark | Emergency Medicine | 701 N. 1st Street, Springfield, IL 62781 | 2008-06-03 |
| 1851486393 | Joan Lewis | Nurse Practitioner | 701 N First St, Springfield, IL 62781 | 2006-10-03 |
| 1548363138 | Pathology Associates of Central Illinois Ltd | Pathology | 701 N First St, Memorial Medical Center, Springfield, IL 62781 | 2006-09-07 |
| 1962511931 | Chad Joseph Defrain | Pathology | 701 N First St, Memorial Medical Center, Springfield, IL 62781 | 2006-08-30 |
| 1346359320 | Nassim Banisaeed | Pathology | 701 N First St, Memorial Medical Center, Springfield, IL 62781 | 2006-08-30 |
| 1922111772 | John E Murphy | Pathology | 701 N First Street, Memorial Medical Center, Springfield, IL 62781 | 2006-08-16 |
| Find all providers in zip 62781 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| 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 |
|---|---|---|---|---|
| 1659313823 | Peter White Jr. | Internal Medicine | 751 N Rutledge St Rm 2100, Springfield, IL 62702-4968 | 2006-06-12 |
| 1558309898 | John R. Carlile | Internal Medicine | 1000 E. Primrose, #200, Springfield, MO 65807-5388 | 2006-06-02 |
| 1134166317 | Moin Ahmed Ranginwala | Internal Medicine | 2029 East High Street, Suite 101, Springfield, OH 45505 | 2006-05-31 |
| 1558311126 | Donald G Gumprecht | Internal Medicine | 543 W Miller St, Springfield, IL 62702-4978 | 2006-05-12 |
| 1083604870 | Chih Ming Chen | Internal Medicine | 2150 Main St, Springfield, MA 01104-3300 | 2005-10-24 |
| 1700275385 | Keivan Shalileh | Internal Medicine | 751 N Rutledge St, Springfield, IL 62702-4968 | 2015-01-20 |
| 1841608890 | Mohammad E Abu Hishmeh | Internal Medicine | 3300 Main Street, 2nd Fl, Suite B, Springfield, MA 01107-1112 | 2014-07-22 |
| 1316353428 | Debdoot Saha | Internal Medicine | 800 E Carpenter St, Springfield, IL 62769 | 2014-07-09 |
| 1528473758 | Ammar Syed | Internal Medicine | 1235 E Cherokee St Rm 194, Springfield, MO 65804-2203 | 2014-06-26 |
| 1710397781 | Olaoluwatomi Kehinde Lamikanra | Internal Medicine | 701 N 1st St, Springfield, IL 62781-0001 | 2014-04-30 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62781 |
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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.