Pradeep G. Kumar MD Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PRADEEP G. KUMAR MD INC

Practice address

3734 7TH Ave
Suite 1
Kenosha, WI 53140-5525

Phone

(262) 654-0226

Fax

(262) 654-0232

NPI assigned

Jan 5, 2008

Last updated

Jan 5, 2008By 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

Dr. Pradeep Gopi Kumar, MD

Title

Owner

Phone

(262) 654-0226

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mariano F Deguzman, MD

  • Pediatric Adolescent Medicine Physician
  • Kenosha, WI
  • NPI 1942369269
  NPD (past)

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

{
    "created_epoch": "1199491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199491200000",
    "number": "1366627689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3734 7TH AVE",
            "address_2": "SUITE 1",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531405525",
            "telephone_number": "262-654-0226",
            "fax_number": "262-654-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3734 7TH AVE",
            "address_2": "SUITE 1",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531405525",
            "telephone_number": "262-654-0226",
            "fax_number": "262-654-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRADEEP G. KUMAR MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-05",
        "last_updated": "2008-01-05",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "PRADEEP",
        "authorized_official_middle_name": "GOPI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-654-0226",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa C Potente, LCSW
• Anupama Potineni
• Nicholas Aaron Potter, B.A.
• Powell Enterprises LLC (Royale Transitional Living Homes)
• Tiffany Powell
• Emily Elizabeth Prahlow, LMFT
• Prairie Orthdontics S.C.
• Carla Doreen Pratt, LPC-IT
• Premier Pediatrics LTD
• Premise Health of Wisconsin Medical SC (City of Kenosha Wellness Center)

• Primary Care Clinic/Center in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Primary Care Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2008; 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.