Sam Reddy Kesri, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

33804 Issued in KY

Practice address

6040 Scottsville Rd
Bowling Green, KY 42104-0388

Phone

(270) 842-5850

Fax

(270) 842-5388

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

• Shyam Murali Keesari Former name

Medicare fee-for-service enrollment

Enrolled in KY

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 1

Specialty

Internal Medicine

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Medical Center (Bowling Green) Hospital, Bowling Green, KY, CCN 180013

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GFABBA/Endpoint/GFABBA

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.

• Adiavni LLC

  • Ophthalmology Physician
  • Bowling Green, KY
  • NPI 1386057818
  NPD

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

• Bowling Green-Warren County Community Hospital Corporation

  • General Acute Care Hospital
  • Bowling Green, KY
  • NPI 1043293608

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1477571925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 SCOTTSVILLE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421040388",
            "telephone_number": "270-842-5850",
            "fax_number": "270-842-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 SCOTTSVILLE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421040388",
            "telephone_number": "270-842-5850",
            "fax_number": "270-842-5388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESRI",
        "first_name": "SAM",
        "middle_name": "REDDY",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "33804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64338049",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHYAM",
            "last_name": "KEESARI",
            "middle_name": "MURALI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William Boyd Kernodle
• Allison J Kerr, O.D.
• Amber Kerr
• Kevin J Kerr, PHARM D.
• Rebecca Kerr, LCSW
• Alexis Key, RN
• Isaiah Key, DC
• Sonnarinh Khamvongsa, APRN
• Umar Khan, M.D.
• Kidney Specialist of Kentucky PLLC

• All providers in Bowling Green, KY
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.