DR. MADHU KIRAN KANCHERLA (NPI# 1942209036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942209036 |
| Entity Type | Individual |
| Full Name | DR. MADHU KIRAN KANCHERLA |
| Credential | M.D. |
| Practice Address |
10012 Kennerly Rd Ste 300 Saint Louis MO 63128-2197 |
| Practice Telephone | 3148420602 |
| Mailing Telephone | 3148420602 |
| Mailing Fax Number | 3148424372 |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2019-01-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
103619 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 204631204 | 05 | |
| MO | 204631212 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1027 Bellevue Ave, Suite 200, Saint Louis, MO 631171851 | 3146456450 | 3146452560 |
| Street Address |
10012 KENNERLY RD STE 300 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128-2197 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982239547 | Mae Armer Weddle | Nurse Practitioner | 10012 Kennerly Rd Ste 300, Saint Louis, MO 63128-2197 | 2020-03-04 |
| 1225468655 | Kathleen Patel | Nurse Practitioner | 10012 Kennerly Rd Ste 300, Saint Louis, MO 63128-2197 | 2013-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1427315423 | Paul Larsen | Internal Medicine | 1027 Bellevue Ave Ste 200, Saint Louis, MO 63117-1851 | 2012-04-13 |
| 1275899718 | Bradley Carl Witbrodt | Internal Medicine | 3023 N Ballas Rd Ste 200, Saint Louis, MO 63131-2330 | 2012-04-10 |
| 1194004952 | Jad Raffoul | Internal Medicine | 1402 S Grand Blvd Fl 14, Saint Louis, MO 63104-1004 | 2011-08-11 |
| 1982999462 | Philip L Mar | Internal Medicine | 3635 Vista Ave Fl 15, Saint Louis, MO 63110-2539 | 2011-06-13 |
| 1255644191 | Rugheed Ghadban | Internal Medicine | 1402 S Grand Blvd Ste 260, Saint Louis, MO 63104-1004 | 2010-07-20 |
| 1962727404 | Tyson E Turner | Internal Medicine | 625 S New Ballas Rd Ste 2015, Saint Louis, MO 63141 | 2010-03-27 |
| 1649468786 | Midwest Cardiovascular, Inc. | Internal Medicine | 1031 Bellevue Ave Ste 200, Saint Louis, MO 63117-1856 | 2007-10-12 |
| 1124225347 | Pradeep Aaron Chandra | Internal Medicine | 11155 Dunn Rd Ste 304e, Saint Louis, MO 63136-6111 | 2007-06-29 |
| 1699856443 | Miguel Angel Paniagua | Internal Medicine | 12414 Lusher Rd, Saint Louis, MO 63138-1456 | 2006-10-18 |
| 1235147109 | Jerome D Cohen | Internal Medicine | 8138 Westmoreland Ave, Provider Enrollment, Saint Louis, MO 63105-3731 | 2006-08-04 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
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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.