Active NPI
Pruthvi Raj Kukunoor, M.D.
- Student in an Organized Health Care Education/Training Program
- Baton Rouge, LA
National Provider Identifier
1770426249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 3401 North Boulevard, Suite 200 Family Health Center
Baton Rouge, LA 70806 - Phone
- (225) 381-6620
- NPI assigned
- Apr 10, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
3401 North Boulevard, Suite 200 Family Health Center
Baton Rouge, LA 70806
Mailing address
3401 North Boulevard, Suite 200 Family Health Center
Baton Rouge, LA 70806
Phone (225) 381-6620
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1775779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788998400000",
"number": "1770426249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 NORTH BOULEVARD, SUITE 200 FAMILY HEALTH CENTER",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "70806",
"telephone_number": "225-381-6620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 NORTH BOULEVARD, SUITE 200 FAMILY HEALTH CENTER",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "70806",
"telephone_number": "225-381-6620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUKUNOOR",
"first_name": "PRUTHVI RAJ",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-04-10",
"last_updated": "2026-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.