Srinivas C Kota MD SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036095253 Issued in IL

Legal business name

SRINIVAS C KOTA MD SC

Practice address

1280 Windham Pkwy
Romeoville, IL 60446-1673

Phone

(630) 378-9785

Fax

(630) 378-9836

NPI assigned

Jan 28, 2011

Last updated

Jan 28, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Srinivas C Kota, M.D.NPI 1659481562

Title

President

Phone

(630) 378-9785

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Srinivas Chakravarthy Kota, MD

  • Internal Medicine Physician
  • Bolingbrook, IL
  • NPI 1659481562
  Medicare reassignment NPD Authorized official
• Rachel J Carlson, APN

  • Nurse Practitioner
  • Romeoville, IL
  • NPI 1497763882
  Medicare reassignment NPD

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1689970360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 WINDHAM PARKWAY",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604461673",
            "telephone_number": "630-378-9785",
            "fax_number": "630-378-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 WINDHAM PKWY",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604461673",
            "telephone_number": "630-378-9785",
            "fax_number": "630-378-9836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRINIVAS C KOTA MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "KOTA",
        "authorized_official_first_name": "SRINIVAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-378-9785",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036095253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036095253",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary Smith
• Jennifer N Smith, ATC
• Keith William Soderlund, PHYSICAL THERAPIST
• Esmeralda Ivonne Soto
• Leonard Morris Spishakoff, MD
• Kimberly Rae Stanczak, PT, DPT
• Nina Elizabeth Stastny, MHS, CCC-SLP/L
• Stephanie Brands Therapy Services LLC
• Jennifer Stewart
• Casey Lynn Sturmon

• Internal Medicine Physician in Romeoville, IL
• Providers in Romeoville, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.