Organization Active NPI

Sri D. Kolli, M.D., P.C.

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1578694881
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
109530 Issued in MO
Legal business name
SRI D. KOLLI, M.D., P.C.
Practice address
10004 Kennerly Rd
Suite 330a
Saint Louis, MO 63128-2141
Phone
(314) 525-4520
Fax
(314) 525-4521
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Authorized official

Name
Mrs. Cynthia Jean Whitener
Title
Office Manager
Phone
(314) 525-4934

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 109530 MO Primary

Addresses

Primary practice location

10004 Kennerly Rd
Suite 330a
Saint Louis, MO 63128-2141

Mailing address

10004 Kennerly Rd
Suite 330a
Saint Louis, MO 63128-2141
Phone (314) 525-4520

Other identifiers 1

IdentifierTypeStateIssuer
DA8462OtherMORAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

12700 Southfork Rd
Ste 207
Saint Louis, MO 63128
Phone (314) 525-4520

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1578694881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD",
            "address_2": "SUITE 330A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-525-4520",
            "fax_number": "314-525-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD",
            "address_2": "SUITE 330A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-525-4520",
            "fax_number": "314-525-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRI D. KOLLI, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "WHITENER",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "314-525-4934",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "109530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA8462",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.