Id Consultants, PC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

MO106962 Issued in MO

Legal business name

ID CONSULTANTS, PC

Practice address

1390 US Highway 61
Suite G1500
Festus, MO 63028-4137

Phone

(636) 933-2344

NPI assigned

Jul 4, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chandra B Dommaraju, MDNPI 1255361135

Title

Owner

Phone

(636) 933-2344

Specialties & licenses 1

Addresses

Other names 1

• DOMMARAJU, PC Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chandra B. Dommaraju, M.D.

  • Infectious Disease Physician
  • Festus, MO
  • NPI 1255361135
  NPD Authorized official

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255361127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29197",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631260197",
            "telephone_number": "314-432-2580",
            "fax_number": "314-432-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 US HIGHWAY 61",
            "address_2": "SUITE G1500",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284137",
            "telephone_number": "636-933-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ID CONSULTANTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DOMMARAJU",
        "authorized_official_first_name": "CHANDRA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-933-2344",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MO",
            "license": "MO106962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOMMARAJU, PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Erik Hume, DO
• Jeneane Hunter
• Christena L Huskey, WHNP-BC
• Catherine E .C. Hutz, MD
• Id Consultants, P.C.
• Image, Ear, Nose & Throat Surgery, Inc.
• Gina N Insalaco
• Interventional Pain Institute, LLC
• Amy Ivacic
• Karthik Iyer, MD

• Infectious Disease Physician in Festus, MO
• Providers in Festus, MO by specialty
• Infectious Disease Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.