KANNAN KANDALLU (NPI# 1740279082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740279082 |
| Entity Type | Individual |
| Full Name | KANNAN KANDALLU |
| Credential | MD |
| Practice Address |
5454 Hohman Ave Hammond IN 46320-1931 |
| Mailing Address |
55 E 86th Ave Po Box 10645 Merrillville IN 46410-6382 |
| Practice Telephone | 2199332006 |
| Practice Fax Number | 2197386714 |
| Mailing Telephone | 2197691670 |
| Mailing Fax Number | 2167386714 |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2012-01-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
01046704 | IN | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
01046704 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200157240 | 05 |
| Street Address |
5454 HOHMAN AVE |
| City | HAMMOND |
| State | IN |
| Zip Code | 46320-1931 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144225491 | Franciscan Health Dyer & Hammond | Home Health | 5454 Hohman Ave, Hammond, IN 46320-1931 | 2005-06-14 |
| 1518587310 | Kristen Brady | Pharmacist | 5454 Hohman Ave, Hammond, IN 46320-1931 | 2020-04-21 |
| 1932738093 | Oluwayomi Olalekan Omosebi | Physical Therapist | 5454 Hohman Ave, Hammond, IN 46320-1931 | 2020-04-02 |
| 1760012231 | Jacob Latham | Pharmacist | 5454 Hohman Ave, Hammond, IN 46320-1931 | 2020-01-23 |
| 1861033060 | Erica Lynn Deenihan | Nurse Practitioner | 5454 Hohman Ave, Hammond, IN 46320-1931 | 2019-09-30 |
| 1568015394 | Danielle Rose Balzano | Registered Nurse | 5454 Hohman Ave, Hammond, IN 46320-1931 | 2019-07-21 |
| 1386104826 | Daniela Lazarevic | Student in an Organized Health Care Education/Training Program | 5454 Hohman Ave, Hammond, IN 46320-1931 | 2019-03-21 |
| 1629533872 | Thomas Blodgett | Nurse Practitioner | 5454 Hohman Ave, Hammond, IN 46320-1931 | 2019-02-01 |
| 1073086252 | Scott T Fairhurst | Nurse Practitioner | 5454 Hohman Ave, Hammond, IN 46320-1931 | 2019-01-10 |
| 1053848622 | Eshwar Nagraj Murthy | Hospitalist | 5454 Hohman Ave, Hammond, IN 46320-1931 | 2017-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225501356 | Miyako S Streeter | Nurse Practitioner | 31 Sibley St Ste A, Hammond, IN 46320 | 2019-01-11 |
| 1700397478 | Prairie Healthcare Services LLC | Home Health | 5920 Hohman Av, Hammond, IN 46320 | 2017-10-20 |
| 1881143469 | Taryn Petty | Nurse Practitioner | 31 Sibley St, Hammond, IN 46320 | 2016-09-23 |
| 1407108079 | Lakeside Behavioral Solutions | Community/Behavioral Health | 5944 1/2 Hohman Ave., Hammond, IN 46320 | 2012-10-08 |
| 1609098607 | Martha Socorro Kozub | Nurse Practitioner | 5514 Hohman Ave., Hammond, IN 46320 | 2007-05-02 |
| 1851414379 | A&k Kouklakis Od. P.C. | Eyewear Supplier (Equipment, not the service) | 1303 165th Street, Hammond, IN 46320 | 2007-04-09 |
| 1639278138 | Syed Sohail Ahmed | Psychiatry & Neurology | 5500 Hohman Avenue, Suite 1e, Hammond, IN 46320 | 2006-09-21 |
| 1215990965 | Trc - Indiana LLC | Clinic/Center | 222 Douglas St, Hammond, IN 46320 | 2006-04-11 |
| 1700845260 | Deepak Ariga | Internal Medicine | 5529 Hohman Avenue, Hammond, IN 46320 | 2006-03-22 |
| 1609869130 | Cathleen M Mcgovern | Emergency Medicine | 5454 S Hohman Ave, Hammond, IN 46320 | 2005-08-30 |
| Find all providers in zip 46320 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285020800 | Noah Mcgill | Radiology | 15790 Paul Vega Md Drive, Radiology, Hammond, LA 70403-7040 | 2015-04-09 |
| 1942498613 | Douglas Matthew Casey | Radiology | 15790 Paul Vega, Md Drive, Radiology Department, Hammond, LA 70403 | 2007-10-09 |
| 1629299730 | Fredrick Austin Lewis | Radiology | 22 Pin Oak Ln, Hammond, LA 70401-8201 | 2007-05-02 |
| 1922081025 | Robert D Reinhart | Radiology | 15790 Paul Vega Dr, Department of Radiology, Hammond, LA 70403-1434 | 2005-11-22 |
| 1679564264 | Roy Divittorio | Radiology | 15837 Paul Vega Md Dr, Suite 200, Hammond, LA 70403-1462 | 2005-11-02 |
| 1174865968 | Sean Michael Gipson | Radiology | 15790 Paul Vega Dr, Hammond, LA 70403-1436 | 2013-03-20 |
| 1831326610 | Matthew Proctor | Radiology | 15790 Paul Vega Md Dr, Radiology Department, Hammond, LA 70403-1434 | 2009-06-18 |
| 1184833188 | Benjamin Wade Wilkerson | Radiology | 15837 Paul Vega Md Dr, Hammond, LA 70403-1495 | 2007-05-22 |
| 1306952957 | Jong Liu | Radiology | 5454 S Hohman Ave, Hammond, IN 46320-1931 | 2006-08-23 |
| 1437175221 | Robert Edmond Smith | Radiology | 15790 Paul Vega Md Dr, Department of Radiology, Hammond, LA 70403-1434 | 2006-07-14 |
| Find all providers in HAMMOND | ||||
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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.