Active NPI
Krishnaveni Gorantla, MD
- Obstetrics & Gynecology Physician
- Munster, IN
National Provider Identifier
1023120805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 01033050A
- Practice address
- 9130 Columbia Ave
Suite B
Munster, IN 46321 - Phone
- (219) 836-8803
- Fax
- (219) 836-8820
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 01033050A | IN | Primary |
Addresses
Primary practice location
9130 Columbia Ave
Suite B
Munster, IN 46321
Mailing address
9130 Columbia Ave
Suite B
Munster, IN 46321
Phone (219) 836-8803
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100169620A | Medicaid | IN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01033050A | IN | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023120805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9130 COLUMBIA AVE",
"address_2": "SUITE B",
"city": "MUNSTER",
"state": "IN",
"postal_code": "46321",
"telephone_number": "219-836-8803",
"fax_number": "219-836-8820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9130 COLUMBIA AVE",
"address_2": "SUITE B",
"city": "MUNSTER",
"state": "IN",
"postal_code": "46321",
"telephone_number": "219-836-8803",
"fax_number": "219-836-8820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORANTLA",
"first_name": "KRISHNAVENI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IN",
"license": "01033050A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100169620A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Munster, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.