Charles Konigsberg Jr., MD

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

0101222148 Issued in VA

Practice address

301 Halifax St
Petersburg, VA 23803-6335

Phone

(804) 863-1652

Fax

(804) 862-6126

NPI assigned

Feb 26, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Advance Community Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Raleigh, NC
  • NPI 1245223783
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1487780490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HALIFAX ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238036335",
            "telephone_number": "804-863-1652",
            "fax_number": "804-862-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HALIFAX ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238036335",
            "telephone_number": "804-863-1652",
            "fax_number": "804-862-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONIGSBERG",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "VA",
            "license": "0101222148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4976053",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ramesh B. Koduri, M.D.
• Sudha Koduru, M.D.
• Michael Tobeh Kometa, M.D.
• Butchaiah Kondragunta, M.D.
• Sakuntla Kondragunta, M.D.
• Tuula H Koraska, L.C.S.W.
• Hannah Kathryn Kraus, FNP-BC
• Krishna Rao Kudaravalli, M.D
• Laboratory Corporation of America Holdings
• Richelle Lackey, PA-C

• Public Health & General Preventive Medicine Physician in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Public Health & General Preventive Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.