Organization Active NPI

Srinivas Kolli MD Inc

  • Gastroenterology Physician
  • Lancaster, OH
National Provider Identifier
1053588855
Registry record updated Nov 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
SRINIVAS KOLLI MD INC
Practice address
1500 East Main Street
Lancaster, OH 43130
Phone
(740) 687-9182
Fax
(740) 687-0278
NPI assigned
May 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2010

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

Authorized official

Name
Dr. Srinivas Kolli, MD
Title
President
Phone
(740) 687-9182

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

1500 East Main Street
Lancaster, OH 43130

Mailing address

1500 East Main Street
Lancaster, OH 43130
Phone (740) 687-9182

Other identifiers 1

IdentifierTypeStateIssuer
0169866MedicaidOH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290988800000",
    "number": "1053588855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 EAST MAIN STREET",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "43130",
            "telephone_number": "740-687-9182",
            "fax_number": "740-687-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 EAST MAIN STREET",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "43130",
            "telephone_number": "740-687-9182",
            "fax_number": "740-687-0278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRINIVAS KOLLI MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-12",
        "last_updated": "2010-11-29",
        "status": "A",
        "authorized_official_last_name": "KOLLI",
        "authorized_official_first_name": "SRINIVAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "740-687-9182",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0169866",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; 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.