Pullatikurthi Pradeep Kumar, M.D.

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

4771325 Issued in TN

Practice address

Corner of Lamont and Sydney
Mountain Home, TN 37684-4000

Phone

(423) 926-1171

Fax

(423) 979-3417

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Baptist Memorial Medical Group Inc

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1306089206

  Radiation Oncology

  NPD

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376643536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 MILLBROOK DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041485",
            "telephone_number": "423-926-1171",
            "fax_number": "423-979-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF LAMONT AND SYDNEY",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376844000",
            "telephone_number": "423-926-1171",
            "fax_number": "423-979-3417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "PULLATIKURTHI",
        "middle_name": "PRADEEP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TN",
            "license": "4771325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Lynn Koder, AU.D.
• Elizabeth Kolberg, AU.D.
• Douglas Lloyd Kozlowski, M.D.
• Jacqueline Kracker, PH.D.
• Vinodini Krishnan, M.D
• Michael D Kuziola, RKT
• Allison Marie Kwiatkowski
• Laura Beth Kyte, P.T.
• Laurie Ann Labudde, FNP
• Nancy Ann Laguardia, PMHNP-BC

• Radiation Oncology Physician in Mountain Home, TN
• Providers in Mountain Home, TN by specialty
• Radiation Oncology Physician in Tennessee

• 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.