NPIMap

Individual provider Active NPI

Kamatchi Ondiveerappan, MD

  • Emergency Medicine Physician
  • Mount Carmel, IL
National Provider Identifier
1003893959
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036083719 Issued in IL
Practice address
1418 College Dr
Mount Carmel, IL 62863-2638
Phone
(618) 263-6302
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036083719 IL Primary

Addresses

Primary practice location

1418 College Dr
Mount Carmel, IL 62863-2638

Mailing address

1706 Coyote Xing
Olney, IL 62450-4334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Marion Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
East Fork Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Good Samaritan Hospital Past Accepting new patients
Mount Vernon Emergency Group PC Emergency Medicine Past Accepting new patients
Good Samaritan Hospital Physician Services Inc. Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363737600000",
    "number": "1003893959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 COYOTE XING",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624504334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 COLLEGE DR",
            "city": "MOUNT CARMEL",
            "state": "IL",
            "postal_code": "628632638",
            "telephone_number": "618-263-6302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONDIVEERAPPAN",
        "first_name": "KAMATCHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2013-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036083719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Carmel, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.