MYDHILI KANUMILLI (NPI# 1023391620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023391620 |
| Entity Type | Individual |
| Full Name | MYDHILI KANUMILLI |
| Credential | M.D |
| Practice Address |
2647 S Saint Elizabeth Blvd Gonzales LA 70737-5021 |
| Practice Telephone | 2256478511 |
| Practice Fax Number | 2256445213 |
| Mailing Telephone | 2256478511 |
| Mailing Fax Number | 2256445213 |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2015-04-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD207526 | LA | Allopathic & Osteopathic Physicians |
| Street Address |
2647 S SAINT ELIZABETH BLVD |
| City | GONZALES |
| State | LA |
| Zip Code | 70737-5021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306844147 | Shawn Hall | Family Medicine | 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021 | 2005-07-13 |
| 1669912689 | Allan L. Edmunds | Nurse Practitioner | 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021 | 2017-02-24 |
| 1528410594 | Jordan Brignac | Nurse Practitioner | 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021 | 2016-07-01 |
| 1063772234 | Swapna Gayathri Kallu | Internal Medicine | 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021 | 2012-05-22 |
| 1770840563 | Kortney West | Pediatrics | 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021 | 2012-04-18 |
| 1760748131 | Laura Frances Black | Physician Assistant | 2647 S Saint Elizabeth Blvd, Gonzales, Gonzales, LA 70737-5021 | 2012-04-10 |
| 1962777219 | Cheri S Landry | Dietitian, Registered | 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021 | 2012-03-20 |
| 1811262165 | Lauren Jones | Dietitian, Registered | 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021 | 2012-03-20 |
| 1114201399 | Our Lady of Lake Ascension, LLC | Health Educator | 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021 | 2011-10-05 |
| 1407137128 | Mandy Lynn Templet | Nurse Practitioner | 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021 | 2011-09-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461593 | Scott G Petrie Md Apmc | Non-Pharmacy Dispensing Site | 1014 West St Clare Boulevard, Ste 1020, Gonzales, LA 70737 | 2020-09-15 |
| 1407461981 | Bryant Louis Bourgeois | Dentist | 13317 N Burnside, Gonzales, LA 70737 | 2020-09-11 |
| 1821612631 | Kene Anje Hamilton | Behavioral Analyst | 1028 East Worthy Street, Gonzales, LA 70737 | 2020-06-08 |
| 1801428636 | Mercedes Francis | Behavior Technician | 1023 E W Worthy Rd, Gonzales, LA 70737 | 2020-02-10 |
| 1407347586 | Functional Dme | Prosthetic/Orthotic Supplier | 219 W. Eastbank St., Ste B, Gonzales, LA 70737 | 2018-05-23 |
| 1235631789 | Transporting On Purpose | Non-emergency Medical Transport (VAN) | 42148 Conifer Drive, Gonzales, LA 70737 | 2018-03-01 |
| 1215453121 | Michelle Fuller Harris | Social Worker | 39094 N Angelle Ct, Gonzales, LA 70737 | 2017-08-22 |
| 1215452529 | Lani Litchfield | Specialist/Technologist | 13341 W. Mill Grove Dr, Gonzales, LA 70737 | 2017-08-08 |
| 1326569369 | Tyler Joshua Turner | Counselor | 1923 South Edwards, Gonzales, LA 70737 | 2017-06-29 |
| 1518408046 | Margaret Madere | Social Worker | 2827 S Ruby Street, Gonzales, LA 70737 | 2017-03-16 |
| Find all providers in zip 70737 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265078877 | Ochsner Clinic LLC | Internal Medicine | 14601 Airline Hwy Ste 103, Gonzales, LA 70737-6658 | 2019-11-19 |
| 1447317722 | Jerry Valentine Williams | Internal Medicine | 317 W Ascension St, Gonzales, LA 70737-2805 | 2007-01-03 |
| 1659476265 | Bogdan L Nowakowski | Internal Medicine | 14076 Highway 44, Gonzales, LA 70737-6901 | 2006-09-14 |
| 1528163326 | David Kwame Tawiah Gboloo | Internal Medicine | 2524 South Philippe Ave, Gonzales, LA 70737 | 2006-09-14 |
| 1326076266 | Carlos R Vazquez | Internal Medicine | 2211 S Burnside Ave, Ste 4, Gonzales, LA 70737-4634 | 2006-06-29 |
| 1669471207 | John Knapp | Internal Medicine | 2647 S. St Elizabeth Blvd, Gonzales, LA 70737-5021 | 2005-07-15 |
| 1871591982 | Paul Cary Aguillard | Internal Medicine | 1702 N Burnside Ave, Gonzales, LA 70737-2141 | 2005-07-12 |
| 1063772234 | Swapna Gayathri Kallu | Internal Medicine | 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021 | 2012-05-22 |
| 1780882290 | Dr Jerry V Williams A Professional Medical Corporation | Internal Medicine | 317 W Ascension St, Gonzales, LA 70737-2805 | 2007-07-05 |
| 1265636658 | Rachel Ann Aaron | Internal Medicine | 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021 | 2007-06-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.