Shraddha Kiran Adwalpalker

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

2017014327 Issued in MO

Practice address

11160 Village North Dr
Saint Louis, MO 63136-6159

Phone

(618) 250-9073

NPI assigned

Aug 11, 2021

Last updated

Aug 11, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1093480022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 ASHLEY PL APT 8",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11160 VILLAGE NORTH DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366159",
            "telephone_number": "618-250-9073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADWALPALKER",
        "first_name": "SHRADDHA",
        "middle_name": "KIRAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2017014327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Email",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11160 Village North Dr",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631366159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Physical Medicine & Rehabilitation Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.