Jeril Anthony Kannampuzha, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

Q9840 Issued in TX

Practice address

1902 Hospital Blvd
Gainesville, TX 76240-2007

Phone

(940) 612-8750

Fax

(940) 668-2663

NPI assigned

Apr 1, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeril.kannampuzha.1@26154.direct.athenahealth.com

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.

• Gainesville Community Hospital, Inc.

  • Rural Health Clinic/Center
  • Gainesville, TX
  • NPI 1033687900
  Medicare reassignment NPD
• Gainesville Community Hospital, Inc.

  • General Practice Physician
  • Gainesville, TX
  • NPI 1942778816

  Pediatrics

  NPD
• Gainesville Community Hospital, Inc.

  • General Acute Care Hospital
  • Gainesville, TX
  • NPI 1972071991
  NPD (past)

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

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1487072906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 HOSPITAL BLVD",
            "city": "GAINESVILLE",
            "state": "TX",
            "postal_code": "762402002",
            "telephone_number": "940-665-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 HOSPITAL BLVD",
            "city": "GAINESVILLE",
            "state": "TX",
            "postal_code": "762402007",
            "telephone_number": "940-612-8750",
            "fax_number": "940-668-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNAMPUZHA",
        "first_name": "JERIL",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-01",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "955120",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q9840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Jones, LPC
• Zaira Jorai-Khan, D.O.
• K & H Wheeler Inc.
• Kab Collective
• Kacye M Vann Nurse Practitioner
• Autum Marie Karr
• Antje Kelling, OTR, MSOT
• Chelsea Marie Kemp, PHARMD
• Kerri Leigh Kennedy-Reiter, L.P.C.
• Kerri Kennedy-Reiter

• Pediatrics Physician in Gainesville, TX
• Providers in Gainesville, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.