Raghu Kanumuri, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036-101187 Issued in IL

Practice address

6800 State Route 162
Maryville, IL 62062-8500

Phone

(800) 968-6866

NPI assigned

Nov 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL, MO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Physicians of St Lukes LLCGroup PAC ID 3779714142, 63 clinicians

Midwest Emergency Anderson Health IncGroup PAC ID 8022401256, 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alton Memorial Hospital Hospital, Alton, IL, CCN 140002
• St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
• Anderson Hospital Hospital, Maryville, IL, CCN 140289
• Community Hospital of Staunton Hospital, Staunton, IL, CCN 141306

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rkanumur@yourcarecommunity.org

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.

• Midwest Emergency Anderson Health, Inc

  • Emergency Medicine Physician
  • Staunton, IL
  • NPI 1710647615
  Medicare reassignment Care Compare group NPD
• Emergency Physicians of St. Luke'S, LLC

  • Emergency Medicine Physician
  • Chesterfield, MO
  • NPI 1215359815
  Medicare reassignment Care Compare group NPD
• Ahs Il Medical Group LLC

  • Clinic/Center
  • Granite City, IL
  • NPI 1659098101
  Medicare reassignment NPD
• Alton-Griffin Emergency Group PC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1891104824
  Medicare reassignment NPD
• Emergency Services Midwest SC

  • Emergency Medicine Physician
  • Belleville, IL
  • NPI 1174024806
  Medicare reassignment NPD
• Midwest Inpatient Anderson Health, Inc

  • Emergency Medicine Physician
  • Maryville, IL
  • NPI 1821758608
  Medicare reassignment NPD
• Southeastern Emergency Physicians of Memphis LLC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1437105277

  MO

  Medicare reassignment NPD
• Curana Health of Missouri-Kansas LLC

  • Family Medicine Physician
  • Lees Summit, MO
  • NPI 1306165337
  Medicare reassignment
• Physician Specialists of St Lukes LLC

  • Internal Medicine Physician
  • Chesterfield, MO
  • NPI 1235168410
  Medicare reassignment
• Granite City Illinois Hospital Company LLC

  • Urgent Care Clinic/Center
  • Glen Carbon, IL
  • NPI 1417353087
  NPD (past)
• Midwest Emergency Department Services Inc

  • Emergency Medicine Physician
  • Belleville, IL
  • NPI 1801843974
  NPD (past)
• Midwest Emergency Services Inc

  • Emergency Medicine Physician
  • Maryville, IL
  • NPI 1841246956
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alton Memorial Hospital

  • Ambulance
  • Alton, IL
  • NPI 1063669117

  Hospital

  Care Compare affiliation
• Alton Memorial Hospital

  • General Acute Care Hospital
  • Alton, IL
  • NPI 1548278476
  Care Compare affiliation
• Anderson Hospital

  • General Acute Care Hospital
  • Maryville, IL
  • NPI 1053481630
  Care Compare affiliation
• Community Hospital of Staunton

  • Critical Access Hospital
  • Staunton, IL
  • NPI 1750308631
  Care Compare affiliation
• St. Lukes Episcopal-Presbyterian Hospital

  • General Acute Care Hospital
  • Chesterfield, MO
  • NPI 1346251543
  Care Compare affiliation

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1700869112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66971",
            "address_2": "DEPT LE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631666971",
            "telephone_number": "800-968-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 STATE ROUTE 162",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628500",
            "telephone_number": "800-968-6866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANUMURI",
        "first_name": "RAGHU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036101187",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-101187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101187",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209158815",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101187-9",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Steven Johnson, M.D.
• David E Johnson, ANP
• Kyle Jones, PHARM.D.
• Melissa S Jordan-Murphy, LCPC CADC
• Sara Kalkenova, LCPC
• Sriraj T. Kanungo, M.D.
• Demetrios A Katsikas, MD
• Christy Anne Kay, ANP
• Malinda Kemper, FNP
• Rachel Kent

• Emergency Medicine Physician in Maryville, IL
• Providers in Maryville, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.