Brahma R Konda, MD PC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

036-101548 Issued in IL

Legal business name

BRAHMA R KONDA, MD PC

Practice address

1314 10TH St
Silvis, IL 61282-1892

Phone

(309) 792-6770

Fax

(309) 792-6772

NPI assigned

Jan 25, 2010

Last updated

Jan 25, 2010By 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

Brahma R Konda

Title

President

Phone

(309) 792-6770

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1264377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264377600000",
    "number": "1306177720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 10TH ST",
            "address_2": "P O BOX 245",
            "city": "SILVIS",
            "state": "IL",
            "postal_code": "612821892",
            "telephone_number": "309-792-6770",
            "fax_number": "309-792-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 10TH ST",
            "city": "SILVIS",
            "state": "IL",
            "postal_code": "612821892",
            "telephone_number": "309-792-6770",
            "fax_number": "309-792-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAHMA R KONDA, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-25",
        "last_updated": "2010-01-25",
        "status": "A",
        "authorized_official_last_name": "KONDA",
        "authorized_official_first_name": "BRAHMA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-792-6770"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": "036-101548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Susan Bull-Welch, LCPC

• Medical Specialty Clinic/Center in Silvis, IL
• Providers in Silvis, IL by specialty
• Medical Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2010; 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.