Active NPI
Neelam Konnur, M.D.
- Pediatrics Physician
- Temple, TX
National Provider Identifier
1972646479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- P0911
- Practice address
- 1901 SW H K Dodgen Loop BLDG 300
Temple, TX 76502-1814 - Phone
- (254) 724-5437
- NPI assigned
- Feb 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 21130 | WV | |
| Pediatrics Physician | 208000000X | P0911 | TX | Primary |
Addresses
Primary practice location
1901 SW H K Dodgen Loop BLDG 300
Temple, TX 76502-1814
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1809324000 | Medicaid | WV |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nkonnur13170@direct.sw.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21130 | WV | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scott & White Clinic | Pediatrics | Current | Accepting new patients |
| Scott & White Clinic | Pediatrics | Current | Accepting new patients |
| Scott & White Hospital - Taylor | Past | Accepting new patients |
Locations
101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100
1901 SW H K Dodgen Loop
Bldg 300
Temple, TX 76502
Phone (254) 935-4888
2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459
Interoperability endpoints
- nkonnur13170@direct.sw.org
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Taylor, TX
- NPI 1659366557
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721952000000",
"number": "1972646479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844658",
"city": "DALLAS",
"state": "TX",
"postal_code": "752844658",
"telephone_number": "254-724-2111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 SW H K DODGEN LOOP BLDG 300",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765021814",
"telephone_number": "254-724-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONNUR",
"first_name": "NEELAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-14",
"last_updated": "2024-07-26",
"certification_date": "2024-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WV",
"license": "21130",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "P0911",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1809324000",
"state": "WV"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nkonnur13170@direct.sw.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1901 SW H K Dodgen Loop Bldg 300",
"city": "Temple",
"state": "TX",
"country_code": "US",
"postal_code": "765021814",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; 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.