Gonguntla V Naidu, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

R6200 Issued in MO

Practice address

5535 Delmar Blvd
Saint Louis, MO 63112-3005

Phone

(314) 879-6363

NPI assigned

May 15, 2006

Sex

Male

Sole proprietor

No

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

State licenses

Practice roles

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.

• Specialty and Primary Care LLC

  • Gastroenterology Physician
  • Saint Louis, MO
  • NPI 1174742720
  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1730130675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 DELMAR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631123005",
            "telephone_number": "314-879-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 DELMAR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631123005",
            "telephone_number": "314-879-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIDU",
        "first_name": "GONGUNTLA",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "R6200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200180008",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Nahmensen, LE, LMT, RN
• Margherita A Nahrup, NP-BC
• Shiva Frank Naidoo, MD
• Sybill Naidoo, PNP
• Sarah Naids, MD
• Rajyalakshmi Gonuguntla Naidu, MD
• Rama G Naidu, MD FACP
• Elizabeth D Nailling
• Uzma Naim, M.D.
• Ajay Nair, MD

• Gastroenterology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Gastroenterology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.