Goutami Kanna Nallamothu, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036096435 Issued in IL

Practice address

2603 S 6TH St
Springfield, IL 62703-3807

Phone

(217) 528-0307

NPI assigned

Dec 14, 2009

Sex

Female

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

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.

• Capitol Healthcare Medical Associates, LLC

  • Internal Medicine Physician
  • Springfield, IL
  • NPI 1982844320
  NPD (past)
• Memorial Medical Center

  • Certified Registered Nurse Anesthetist
  • Springfield, IL
  • NPI 1255393112
  NPD (past)
• Siu Physicians & Surgeons, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
  • NPI 1558385989

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1730418229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4566",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627084566",
            "telephone_number": "800-577-5368",
            "fax_number": "217-757-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627033807",
            "telephone_number": "217-528-0307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLAMOTHU",
        "first_name": "GOUTAMI",
        "middle_name": "KANNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-14",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036096435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSE",
            "identifier": "036096435",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charmaine Haikaeli Mziray-Andrew, M.D.
• Kathleen Ann Nacke, NNP
• Robert Nadler, MD
• Kristina Lynn Nagel, RPH
• Sanjai Nagendra, MD
• Namaste Psychiatry PLLC
• Parashar J Nanavati, M.D.
• Shailesh S Nandish, M.D.
• Keerthi Nannapaneni
• Malehia Naqvi, IBCLC

• Internal Medicine Physician in Springfield, IL
• Providers in Springfield, 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 Dec 14, 2009; 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.