Active NPI
Nano Consultancy Services LLC
- Geriatric Medicine (Internal Medicine) Physician
- Saint Louis, MO
National Provider Identifier
1306255708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- Legal business name
- NANO CONSULTANCY SERVICES LLC
- Practice address
- 11628 Old Ballas Rd
Suite 212
Saint Louis, MO 63141-7030 - Phone
- (561) 573-2592
- NPI assigned
- Aug 11, 2014
- 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
- Raghu Immadisetty
- Title
- Managing Director
- Phone
- (561) 573-2592
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | Primary |
Addresses
Primary practice location
11628 Old Ballas Rd
Suite 212
Saint Louis, MO 63141-7030
Mailing address
11628 Old Ballas Rd
Suite 212
Saint Louis, MO 63141-7030
Phone (561) 573-2592
Other names 1
- Gateway Transitionalists
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407715200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1409097600000",
"number": "1306255708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11628 OLD BALLAS RD",
"address_2": "SUITE 212",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631417030",
"telephone_number": "561-573-2592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11628 OLD BALLAS RD",
"address_2": "SUITE 212",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631417030",
"telephone_number": "561-573-2592"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NANO CONSULTANCY SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-08-11",
"last_updated": "2014-08-27",
"status": "A",
"authorized_official_last_name": "IMMADISETTY",
"authorized_official_first_name": "RAGHU",
"authorized_official_title_or_position": "MANAGING DIRECTOR",
"authorized_official_telephone_number": "561-573-2592"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Gateway Transitionalists",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.