Individual provider Active NPI

Bindu Reddy, M.D.

  • Pediatrics Physician
  • Carbondale, IL
National Provider Identifier
1215914775
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036114150 Issued in IL
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

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
036114150MedicaidIL

Other names 1

  • Mrs. Bindu Kotrakona Former name

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

LicenseStateTypeSpecialty
036114150ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Group LLC Pediatrics Past Accepting new patients
Pediatric Group LLC Pediatrics Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11869/brand/1/csg/1/fhir/r4
  • Direct secure messaging: 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.

Verify at the official NPI Registry.