Active NPI
Bindu Reddy, M.D.
- Pediatrics Physician
- Carbondale, IL
National Provider Identifier
1215914775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036114150
- Practice address
- 1175 Cedar CT
Carbondale, IL 62901-5333 - Phone
- (618) 993-0404
- Fax
- (618) 993-1717
- NPI assigned
- Dec 27, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036114150 | IL | Primary |
Addresses
Primary practice location
1175 Cedar CT
Carbondale, IL 62901-5333
Mailing address
3412 Office Park Dr
Marion, IL 62959-6477
Phone (618) 993-0404
Other practice location 1
310 W Saint Louis St
West Frankfort, IL 62896-2037
Phone (618) 993-0404
Other practice location 2
3412 Office Park Dr
Marion, IL 62959-6477
Phone (618) 993-0404
Other practice location 3
28 Veterans Dr
Harrisburg, IL 62946-3320
Phone (618) 993-0404
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036114150 | Medicaid | IL |
Other names 1
- Mrs. Bindu Kotrakona
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036114150 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Group LLC | Pediatrics | Past | Accepting new patients |
| Pediatric Group LLC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/11869/brand/1/csg/1/fhir/r4
- bindu.reddy.1@11869.direct.athenahealth.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775606400000",
"number": "1215914775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3412 OFFICE PARK DR",
"city": "MARION",
"state": "IL",
"postal_code": "629596477",
"telephone_number": "618-993-0404",
"fax_number": "618-993-1717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 CEDAR CT",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629015333",
"telephone_number": "618-993-0404",
"fax_number": "618-993-1717"
}
],
"practiceLocations": [
{
"address_1": "310 W Saint Louis St",
"address_purpose": "LOCATION",
"city": "West Frankfort",
"state": "IL",
"postal_code": "628962037",
"country_code": "US",
"telephone_number": "618-993-0404",
"fax_number": "618-993-1717",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3412 Office Park Dr",
"address_purpose": "LOCATION",
"city": "Marion",
"state": "IL",
"postal_code": "629596477",
"country_code": "US",
"telephone_number": "618-993-0404",
"fax_number": "618-993-1717",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "28 Veterans Dr",
"address_purpose": "LOCATION",
"city": "Harrisburg",
"state": "IL",
"postal_code": "629463320",
"country_code": "US",
"telephone_number": "618-993-0404",
"fax_number": "618-993-1717",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REDDY",
"first_name": "BINDU",
"name_prefix": "Mrs.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-12-27",
"last_updated": "2026-04-08",
"certification_date": "2026-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036114150",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036114150",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BINDU",
"last_name": "KOTRAKONA",
"prefix": "MRS.",
"credential": "M.D",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Carbondale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.