Active NPI
Ramaprasad Konanur, M.D
- Hospitalist Physician
- Normal, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 036-111825
- Practice address
- 1300 Franklin Ave
Suite 250
Normal, IL 61761-3592 - Phone
- (309) 268-3589
- Fax
- (309) 268-2536
- NPI assigned
- Jul 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 036-111825 | IL | Primary |
Addresses
Primary practice location
1300 Franklin Ave
Suite 250
Normal, IL 61761-3592
Mailing address
1300 Franklin Ave
Suite 250
Normal, IL 61761-3592
Phone (309) 268-3589
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00183517 | Other | IL | MEDICARE RAILROAD |
| 36111825 | Medicaid | IL | |
| 95016 | Other | IL | HEALTHALLIANCE |
| 5715390 | Other | IL | BCBS |
| 809840018 | Other | IL | MEDICARE INDIVIDUAL PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
530 Neglen Oak Ave
Peoria, IL 61637-0001
Phone (309) 624-8818
Hospital & facility affiliations
- Saint Francis Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-111825 | IL | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current | Accepting new patients |
Locations
1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870
1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249344000000",
"number": "1336172121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 FRANKLIN AVE",
"address_2": "SUITE 250",
"city": "NORMAL",
"state": "IL",
"postal_code": "617613592",
"telephone_number": "309-268-3589",
"fax_number": "309-268-2536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 FRANKLIN AVE",
"address_2": "SUITE 250",
"city": "NORMAL",
"state": "IL",
"postal_code": "617613592",
"telephone_number": "309-268-3589",
"fax_number": "309-268-2536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONANUR",
"first_name": "RAMAPRASAD",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-08",
"last_updated": "2009-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IL",
"license": "036-111825",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00183517",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36111825",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHALLIANCE",
"identifier": "95016",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "5715390",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE INDIVIDUAL PTAN",
"identifier": "809840018",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Normal, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.