Active NPI
Atkavi Sawadisavi, MD
- Surgery Physician
- Pinckneyville, IL
National Provider Identifier
1144211764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Practice address
- 101 N Walnut St
Pinckneyville, IL 62274-1034 - Phone
- (618) 357-5920
- Fax
- (618) 357-3096
- NPI assigned
- Nov 2, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | IL | Primary |
Addresses
Primary practice location
101 N Walnut St
Pinckneyville, IL 62274-1034
Mailing address
PO Box 220
Pinckneyville, IL 62274-0220
Phone (918) 357-5920
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-046330 | IL | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144211764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 220",
"city": "PINCKNEYVILLE",
"state": "IL",
"postal_code": "622740220",
"telephone_number": "918-357-5920",
"fax_number": "618-357-3096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 N WALNUT ST",
"city": "PINCKNEYVILLE",
"state": "IL",
"postal_code": "622741034",
"telephone_number": "618-357-5920",
"fax_number": "618-357-3096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAWADISAVI",
"first_name": "ATKAVI",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pinckneyville, IL
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.