Gavini Medical Group,LTD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

R6940 Issued in MO

Legal business name

GAVINI MEDICAL GROUP,LTD

Practice address

10000 Watson Rd
2L-24
Saint Louis, MO 63126-1854

Phone

(314) 822-7033

Fax

(314) 822-3666

NPI assigned

Aug 25, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Laura Annette Hawkins, RMA

Title

Office Manager

Phone

(314) 822-7033

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Floyd Adderley, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Festus, MO
  • NPI 1114149903

  General Practice

  NPD (past)
• Mary C Bauer, RN, MSN, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Clayton, MO
  • NPI 1427006337
  NPD (past)
• Baolin Fan, MD

  • Internal Medicine Physician
  • St Louis, MO
  • NPI 1568568897
  NPD (past)
• Rajendra Gavini, M.D.

  • General Practice Physician
  • Saint Louis, MO
  • NPI 1053501973
  NPD (past)
• Katepalle J Moorthy, MD

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1902879802
  NPD (past)
• Venkata Pante, MD

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1356314298
  NPD (past)
• Sanjay A Patwardhan, M.D.

  • Internal Medicine Physician
  • Chesterfield, MO
  • NPI 1073583803
  NPD (past)
• Irfan Idrees, MD

  • Internal Medicine Physician
  • Purcellville, VA
  • NPI 1134171218
  NPD (past)
• Sriraj T. Kanungo, M.D.

  • Nephrology Physician
  • Maryville, IL
  • NPI 1548355621
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1912014606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 WATSON RD",
            "address_2": "2L-24",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631261854",
            "telephone_number": "314-822-7033",
            "fax_number": "314-822-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 WATSON RD",
            "address_2": "2L-24",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631261854",
            "telephone_number": "314-822-7033",
            "fax_number": "314-822-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAVINI MEDICAL GROUP,LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "ANNETTE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "314-822-7033",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RMA"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "MO",
            "license": "R6940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BC/BS OF MO",
            "identifier": "997",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "011155588",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "501758304",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS SHIELD OF MO",
            "identifier": "17766",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Grainger Gauthier
• Melissa Gauthier
• Donna Gauvain
• Emily Bridget Gavin, ACNP
• Gavin'S Heathcare Management LLC
• Rajendra Gavini, M.D.
• Marisel Gaviria Robertson, LMSW
• Malak Gawdat
• Dianne Cheryl Gawedzinski, L.P.C.
• Hiram Alberto Gay, MD

• General Practice Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• General Practice Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.