Kota Medical PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

01038987 Issued in IN

Legal business name

KOTA MEDICAL PC

Practice address

3630 Willowcreek Rd
Portage, IN 46368-5075

Phone

(219) 759-5812

Fax

(219) 759-5890

NPI assigned

Aug 14, 2008

Organization subpart

No

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

Authorized official

Name

Ranga Rao Kota, MD

Title

Owner

Phone

(219) 759-5812

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364428800000",
    "number": "1063668614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 WILLOWCREEK RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463685075",
            "telephone_number": "219-759-5812",
            "fax_number": "219-759-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 WILLOWCREEK RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463685075",
            "telephone_number": "219-759-5812",
            "fax_number": "219-759-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOTA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-14",
        "last_updated": "2013-03-28",
        "status": "A",
        "authorized_official_last_name": "KOTA",
        "authorized_official_first_name": "RANGA",
        "authorized_official_middle_name": "RAO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-759-5812",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01038987",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01038987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200007810",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Marie Davidson Kimes, APRN, FNP
• Elizabeth King, PHARMD
• Nicole L Kirkland, PTA
• Olesya Anna Klocek, OTR/L
• Teri Koch, MSN, RN, FNP-BC
• Ranga R Kota, M.D.
• Stephanie Kotarski
• Katrina M Kozub, FNP
• James Kremer, PTA
• Diane Krise, RPH

• Gastroenterology Physician in Portage, IN
• Providers in Portage, IN by specialty
• Gastroenterology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.