Subbia G Jagannathan, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036046940 Issued in IL

Practice address

695 N Kellogg St
Galesburg, IL 61401-2807

Phone

(309) 345-4219

NPI assigned

May 23, 2006

Last updated

May 12, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Galesburg Radiology Associates, S.C.

  • Diagnostic Radiology Physician
  • Galesburg, IL
  • NPI 1285667311
  NPD (past) Authorized official
• Cira Michigan PC

  • Diagnostic Radiology Physician
  • Escanaba, MI
  • NPI 1972141513
  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1184679953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 989",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614020989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 N KELLOGG ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012807",
            "telephone_number": "309-345-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGANNATHAN",
        "first_name": "SUBBIA",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036046940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360469401",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300026080",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• J.H. Rigsby III, M.D. LLC
• J&S Kelly Galesburg, LLC (Kelly's Medical Equipment & Supply of Illinois)
• Stephanie Megan Jackson, OTD, OTR/L
• Victoria Grace Jackson, PHARM.D
• Hamsaveni K Jagannathan, MD
• Erin Jain, DMD
• Neha Jain, MD
• Nilufar Jalali, PHARMD
• James R Ruppel MD LLC
• Brij B Jamnadas, M.D.

• Diagnostic Radiology Physician in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.