Archana Kodali, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MT203115 Issued in PA

Practice address

3535 Southern Blvd
Kettering, OH 45429-1298

Phone

(937) 298-4331

NPI assigned

Mar 13, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: akodali57215@epicdirect.rwjbh.org

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1619218864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291298",
            "telephone_number": "937-298-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291298",
            "telephone_number": "937-298-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODALI",
        "first_name": "ARCHANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-13",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT203115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie V Knott, M.D.
• Joan S Koble, CRNFA
• Kathryn Keyes Koble, NP
• Christian E. Koch, M.D.
• Sara Lynn Kocian, DO
• Gregory Stephen Kohls, M.D.
• Keri Kolker
• Susan M Komorowski, MD
• Scott David Koncal, MD
• Min Kong, PHARM. D.

• Internal Medicine Physician in Kettering, OH
• Providers in Kettering, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.