S.B.Kondragunta LLC

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

0101223780 Issued in VA

Legal business name

S.B.KONDRAGUNTA LLC

Practice address

34-G Medical Park Blvd.,
Suite - G
Petersburg, VA 23805-9283

Phone

(804) 722-3100

Fax

(804) 722-3120

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Butchaiah Kondragunta, M.D

Title

Owner

Phone

(804) 722-3100

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sakuntla Kondragunta, M.D.

  • Hospitalist Physician
  • Petersburg, VA
  • NPI 1184695843
  NPD (past)
• Nishanth Sukumaran, MD

  • Hematology & Oncology Physician
  • Petersburg, VA
  • NPI 1538328844
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337817600000",
    "number": "1316020399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 MEDICAL PARK BLVD STE G",
            "address_2": "SUITE - G",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059283",
            "telephone_number": "804-722-3100",
            "fax_number": "804-722-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34-G MEDICAL PARK BLVD.,",
            "address_2": "SUITE - G",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059283",
            "telephone_number": "804-722-3100",
            "fax_number": "804-722-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S.B.KONDRAGUNTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2012-05-24",
        "status": "A",
        "authorized_official_last_name": "KONDRAGUNTA",
        "authorized_official_first_name": "BUTCHAIAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-722-3100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "VA",
            "license": "0101223780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1316020399",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "258076",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD",
            "identifier": "110214242",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5839777",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD",
            "identifier": "P00271749",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrei Rodin, LPC
• Hannah Margaret Roper, PA-C
• Myeshia Rose
• Michael O Royster, MD, MPH
• Ashely Ryan, LPC
• Shah Zaman Saeed
• Safe Haven Adult Residential Enhancement
• Safe Haven Family Services, LLC
• Safe N Sound LLC
• Sajid Naveed, MD, LLC

• Hematology & Oncology Physician in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Hematology & Oncology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.