Prasad Kommareddi, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301039876 Issued in MI

Practice address

8426 Warwick Groves Court
Grand Blanc, MI 48439

Phone

(810) 869-9808

NPI assigned

Sep 29, 2006

Last updated

Jun 21, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: pkommareddi573965@direct.hfhs.org

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1669564498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8426 WARWICK GROVES COURT",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "48439",
            "telephone_number": "810-869-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8426 WARWICK GROVES COURT",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "48439",
            "telephone_number": "810-869-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMMAREDDI",
        "first_name": "PRASAD",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301039876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3235762",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Knight Drugs Grand Blanc, Inc.
• Kyle Thompson Knight, DO
• Cody Martin Knuppenburg, D.O.
• Christopher Kocharians, MD
• Evan Kohler, MD
• Alicia Konecny
• Carla Anne Koon, LLPC
• Olivia Korhonen
• Joel Fredric Kortge
• Erica Kovacs, LMSW

• Internal Medicine Physician in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.