Individual provider Active NPI

Kurmanadha Chadalawada, MD

  • Internal Medicine Physician
  • Arnold, MO
National Provider Identifier
1396771606
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
105197 Issued in MO
Practice address
3619 Richardson Square Dr
Suite 150
Arnold, MO 63010-6022
Phone
(636) 461-1414
Fax
(636) 461-2013
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 105197 MO Primary

Addresses

Primary practice location

3619 Richardson Square Dr
Suite 150
Arnold, MO 63010-6022

Mailing address

PO Box 797052
Saint Louis, MO 63179-7000
Phone (314) 878-0163

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031203000679 MO Practitioner - Internal Medicine 9032014972 Reassigns benefits to 1 organization
I20120301000664 IL Practitioner - Internal Medicine 9032014972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medwin Primary Care L.L.C.Group PAC ID 0446203236, 3 clinicians

Practice addresses (Care Compare)

123 Wedgewood Dr
Columbia, IL 62236-1052
Phone (618) 281-2233

3619 Richardson Square Dr
Suite 150
Arnold, MO 63010-6021
Phone (636) 461-1414

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Medwin Primary Care L.L.C. Internal Medicine CurrentSince Jan 1, 2005 Accepting new patients
Family Medicine in Columbia PastSince Dec 27, 2011 Accepting new patients
Inpatient Consultants of Missouri Inc Internal Medicine Past Accepting new patients

Locations

123 Wedgewood Dr
Columbia, IL 62236
Phone (618) 281-2233

3619 Richardson Square Dr
Ste 150
Arnold, MO 63010
Phone (636) 461-1414

3619 Richardson Square Dr
Arnold, MO 63010
Phone (636) 461-1414

1688 Gravois Rd
High Ridge, MO 63049
Phone (636) 677-5776

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1396771606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 797052",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631797000",
            "telephone_number": "314-878-0163",
            "fax_number": "314-878-4562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3619 RICHARDSON SQUARE DR",
            "address_2": "SUITE 150",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630106022",
            "telephone_number": "636-461-1414",
            "fax_number": "636-461-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHADALAWADA",
        "first_name": "KURMANADHA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "105197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arnold, MO

Sources for this page

Verify at the official NPI Registry.