Individual provider Active NPI

Nicholas Amruth Koneri, M.D.

  • Emergency Medicine Physician
  • San Antonio, TX
National Provider Identifier
1366898611
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
S0175 Issued in TX
Practice address
11503 NW Military Hwy Ste 202
San Antonio, TX 78231-1895
Phone
(210) 233-6363
NPI assigned
May 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X S0175 TX Primary

Addresses

Primary practice location

11503 NW Military Hwy Ste 202
San Antonio, TX 78231-1895

Mailing address

3301 Crystal Falls Ave
Edinburg, TX 78539-1800
Phone (956) 467-8900

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1366898611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 CRYSTAL FALLS AVE",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785391800",
            "telephone_number": "956-467-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11503 NW MILITARY HWY STE 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782311895",
            "telephone_number": "210-233-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONERI",
        "first_name": "NICHOLAS",
        "middle_name": "AMRUTH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-05",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S0175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.