Individual provider Active NPI

Krishna Gandotra, M.D.

  • Adolescent Medicine (Internal Medicine) Physician
  • Washington, DC
National Provider Identifier
1356455190
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
D43702 Issued in MD
Practice address
Walter Reed Army Medical Ctr
6900 Georgia Ave., NW
Washington, DC 20307-0001
Phone
(202) 685-3100
Fax
(202) 685-2766
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X D43702 MD Primary

Addresses

Primary practice location

Walter Reed Army Medical Ctr
6900 Georgia Ave., NW
Washington, DC 20307-0001

Mailing address

303 Concert Way
Baltimore, MD 21228-5565
Phone (202) 685-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D43702MDMDAdolescent Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356455190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 CONCERT WAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212285565",
            "telephone_number": "202-685-3100",
            "fax_number": "202-685-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WALTER REED ARMY MEDICAL CTR",
            "address_2": "6900 GEORGIA AVE., NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "203070001",
            "telephone_number": "202-685-3100",
            "fax_number": "202-685-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDOTRA",
        "first_name": "KRISHNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "MD",
            "license": "D43702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.