DR. PRANAV KIDAMBI (NPI# 1861892556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861892556 |
| Entity Type | Individual |
| Full Name | DR. PRANAV KIDAMBI |
| Credential | MD |
| Practice Address |
4100 Lake Dr Se Ste 200 Grand Rapids MI 49546-8292 |
| Mailing Address |
100 Michigan St Ne # Mc845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6162678244 |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2020-08-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
4301501996 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
4100 LAKE DR SE STE 200 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-8292 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477548832 | Robert A Burghduf Jr. | Physician Assistant | 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546-8292 | 2005-09-13 |
| 1023648912 | Breanne Renae Cook | Nurse Practitioner | 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546-8292 | 2020-01-21 |
| 1588204598 | Sarah Elizabeth Knoll | Nurse Practitioner | 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546-8292 | 2020-01-08 |
| 1710450259 | Bridget Leigh Schafer | Nurse Practitioner | 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546-8292 | 2019-01-08 |
| 1043797830 | Janiece Ann Feuerstein | Nurse Practitioner | 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546-8292 | 2018-07-24 |
| 1457837460 | Alyssa Shea Caminata | Nurse Practitioner | 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546-8292 | 2018-07-12 |
| 1326577404 | Caitlin Megan Greene | Physician Assistant | 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546-8292 | 2017-06-12 |
| 1881138220 | Courtney Golding | Psychologist | 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546-8292 | 2016-12-05 |
| 1194178178 | Ravi Kanth Velagapudi | Internal Medicine | 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546-8292 | 2016-07-14 |
| 1942652961 | Disha Geriani | Internal Medicine | 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546-8292 | 2016-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| 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 |
|---|---|---|---|---|
| 1588899595 | Michigan Medical Patient Care | Internal Medicine | 2902 Bradford Street Ne, Grand Rapids, MI 49525 | 2009-05-19 |
| 1508973538 | David A Listello | Internal Medicine | 3200 Eagle Park Dr Ne, Ste 102, Grand Rapids, MI 49525-7057 | 2006-08-24 |
| 1942652961 | Disha Geriani | Internal Medicine | 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546-8292 | 2016-07-02 |
| 1801214226 | David Andrew Folt | Internal Medicine | 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546-8292 | 2014-04-02 |
| 1457779274 | Kevin Charles Patterson | Internal Medicine | 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546-8292 | 2014-03-29 |
| 1013357722 | Stephen Thomas Doyle | Internal Medicine | 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546-8292 | 2013-06-26 |
| 1487948329 | Sheila Krishnan | Internal Medicine | 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546-8292 | 2011-06-08 |
| 1982835567 | Anupam Kumar | Internal Medicine | 4100 Lake Dr Se, Suite 200, Grand Rapids, MI 49546-8292 | 2009-07-30 |
| 1295977221 | John Patrick Egan IIi | Internal Medicine | 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546 | 2009-04-06 |
| 1811134562 | Maximiliano Andres Tamae Kakazu | Internal Medicine | 4100 Lake Dr Se, Suite 200, Grand Rapids, MI 49546-8292 | 2009-01-16 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
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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.