B. S. Kesavan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036052418 Issued in IL

Practice address

834 N Seminary St
Suite 302
Galesburg, IL 61401-2852

Phone

(309) 342-2171

Fax

(309) 342-7205

NPI assigned

Jul 18, 2005

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

Other identifiers 1

Other names 1

• Bramandaswamy Shanmugakesavan Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1396744868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 N SEMINARY ST",
            "address_2": "SUITE 302",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012852",
            "telephone_number": "309-342-2171",
            "fax_number": "309-342-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 N SEMINARY ST",
            "address_2": "SUITE 302",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012852",
            "telephone_number": "309-342-2171",
            "fax_number": "309-342-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESAVAN",
        "first_name": "B.",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036052418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360524181",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRAMANDASWAMY",
            "last_name": "SHANMUGAKESAVAN",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kccdd, Inc.
• Kccdd, Inc.
• Kehoe Eye Care PC
• Peter H Kehoe, OD
• Kensington of Galesburg
• Jamie Christine Key, LPN
• Afshin A Khaiser, M.D.
• Noor Ahamed Khaiser, M.D.
• Brad King, MHP
• Brenda King, MHP

• Pediatrics Physician in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; 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.