Channakeshava Rayan Indira, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

CI040238 Issued in MI

Practice address

4370 Fashion Square Blvd
Saginaw, MI 48603-5221

Phone

(989) 799-5441

Fax

(989) 799-3590

NPI assigned

May 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• C Indira Professional name

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972555977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 FASHION SQUARE BLVD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486035221",
            "telephone_number": "989-799-5441",
            "fax_number": "989-799-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 FASHION SQUARE BLVD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486035221",
            "telephone_number": "989-799-5441",
            "fax_number": "989-799-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDIRA",
        "first_name": "CHANNAKESHAVA",
        "middle_name": "RAYAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "CI040238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C",
            "last_name": "INDIRA",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Pulmonary Disease Physician in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Pulmonary Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.