Kallanagouda Nandihalli, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301040630 Issued in MI

Practice address

711 S Health Pkwy
Suite 4
Three Rivers, MI 49093-9387

Phone

(269) 273-8557

Fax

(269) 279-6461

NPI assigned

Nov 16, 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 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/threeri-78cadb4b

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.

• Three Rivers Hospitalists PLLC

  • Hospitalist Physician
  • Three Rivers, MI
  • NPI 1942585880
  NPD (past)

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1447232418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S HEALTH PKWY",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938352",
            "telephone_number": "269-273-9789",
            "fax_number": "269-273-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S HEALTH PKWY",
            "address_2": "SUITE 4",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490939387",
            "telephone_number": "269-273-8557",
            "fax_number": "269-279-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANDIHALLI",
        "first_name": "KALLANAGOUDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301040630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3146760 10",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4459984 10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "700G560080",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4459993 10",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4892292 10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "1107500091",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4258500 10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Constance Mumford
• Kimberly Joy Myers, FNP-C
• William Charles Myers, FNP
• Myeyedr Optometry of Michigan, LLC (RX Optical)
• Becky Nagy, PSYD
• Marceline Aleece Nevins, OTR
• Peter Newhouse
• Erin K Nowak, MS, OTR, CHT
• Heidi R Olivares, LMSW
• Norman Olken, MD

• Internal Medicine Physician in Three Rivers, MI
• Providers in Three Rivers, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.