Active NPI
Panduranga R Kini MD, LTD
- Neurology Physician
- Swansea, IL
National Provider Identifier
1225266984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 036064310
- Legal business name
- PANDURANGA R KINI MD, LTD
- Practice address
- 7 Park PL Ste a
Swansea, IL 62226-2916 - Phone
- (618) 233-1151
- Fax
- (618) 235-1079
- NPI assigned
- Jul 1, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Panduranga R Kini, MD
- Title
- Owner
- Phone
- (618) 233-1151
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 036064310 | IL | Primary |
Addresses
Primary practice location
7 Park PL Ste a
Swansea, IL 62226-2916
Mailing address
7 Park Place
Ste a
Swansea, IL 62226-2916
Phone (618) 233-1151
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08200528 | Other | BCBS | |
| 130000629 | Other | IL | RR MEDICARE |
| 100708 | Other | IL | HEALTHLINK |
| 34490 | Other | GHP | |
| 4000537 | Other | IL | AETNA |
| 036064310 | Medicaid | IL |
National Provider Directory
National Provider DirectoryLocations
7 Park Pl
Ste A
Swansea, IL 62226
Phone (618) 233-1151
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246406400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1254787200000",
"number": "1225266984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 PARK PLACE",
"address_2": "STE A",
"city": "SWANSEA",
"state": "IL",
"postal_code": "622262916",
"telephone_number": "618-233-1151",
"fax_number": "618-235-1079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 PARK PL STE A",
"city": "SWANSEA",
"state": "IL",
"postal_code": "622262916",
"telephone_number": "618-233-1151",
"fax_number": "618-235-1079"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PANDURANGA R KINI MD, LTD",
"organizational_subpart": "NO",
"enumeration_date": "2009-07-01",
"last_updated": "2009-10-06",
"status": "A",
"authorized_official_last_name": "KINI",
"authorized_official_first_name": "PANDURANGA",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "618-233-1151",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IL",
"license": "036064310",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "08200528",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "130000629",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "100708",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHP",
"identifier": "34490",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4000537",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036064310",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Swansea, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.