Konda BC Mouli, MD PC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

KONDA BC MOULI, MD PC

Practice address

777 Kimole LN
Suite 260
Adrian, MI 49221-1478

Phone

(517) 265-4770

NPI assigned

Feb 5, 2008

Organization subpart

No

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

Authorized official

Name

Julie Holdridge

Title

Billing Specialist

Phone

(517) 265-0229

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227571200000",
    "number": "1376721035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 KIMOLE LN",
            "address_2": "SUITE 260",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211478",
            "telephone_number": "517-265-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 KIMOLE LN",
            "address_2": "SUITE 260",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211478",
            "telephone_number": "517-265-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONDA BC MOULI, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-11-25",
        "status": "A",
        "authorized_official_last_name": "HOLDRIDGE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "517-265-0229"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "340D610140",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Kiss
• Ryan Knape
• Ashley H Knight-Dejonghe
• David Knox
• Shelby Kolasinski, PT, DPT
• Jodi Lynn Kordyzon, OD
• Kyria Kozack
• Carlee Renee Kremski
• Jessica Kremski, CMT
• Jordan Patrick Krucek

• Urology Physician in Adrian, MI
• Providers in Adrian, MI by specialty
• Urology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.