DR. KOLLI PRABHAKARA REDDY (NPI# 1073514543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073514543 |
| Entity Type | Individual |
| Full Name | DR. KOLLI PRABHAKARA REDDY |
| Credential | MD |
| Practice Address |
520 Sw 5th Ave Williston FL 32696 |
| Practice Telephone | 3525283770 |
| Practice Fax Number | 3525280691 |
| Mailing Telephone | 3525283770 |
| Mailing Fax Number | 3525280691 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME21372 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
520 SW 5TH AVE |
| City | WILLISTON |
| State | FL |
| Zip Code | 32696 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962060939 | Quick Care Med LLC | Non-Pharmacy Dispensing Site | 517 W Noble Ave, Williston, FL 32696 | 2019-06-04 |
| 1346770930 | Michelle Yvette Dempsey | Home Health Aide | 931 Ne 207th Ave, Williston, FL 32696 | 2017-06-15 |
| 1801157185 | Pratibha Lumb | Family Medicine | 630 N. Main Street, Williston, FL 32696 | 2012-06-04 |
| 1821261306 | Raymond T Webber | Dentist | 610 Sw 1st Ave, Williston, FL 32696 | 2008-04-07 |
| 1003912635 | Jeremie Joseph Young | General Practice | 125 Sw 7th Street, Williston, FL 32696 | 2006-09-14 |
| 1578584884 | Winn Dixie Stores Inc | Durable Medical Equipment & Medical Supplies | 727 W Noble Ave, Williston, FL 32696-1515 | 2006-07-21 |
| 1841631249 | Lawrence C Rush Jr. | Pharmacist | 727 W Noble Ave, Williston, FL 32696-1515 | 2013-07-13 |
| 1952401648 | Teresa Sever | Pharmacist | 727 W Noble Ave, Williston, FL 32696-1515 | 2006-09-23 |
| 1497060784 | Priscilla Smith | Social Worker | 18990 Ne 49th St, Williston, FL 32696-1555 | 2010-08-11 |
| 1902879158 | Stephen S Falkowski | Family Medicine | 630 N Main St, Williston, FL 32696-1705 | 2006-02-08 |
| Find all providers in zip 32696 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801157185 | Pratibha Lumb | Family Medicine | 630 N. Main Street, Williston, FL 32696 | 2012-06-04 |
| 1265520605 | William E Code | Family Medicine | 1102 Main, Williston, ND 58801 | 2006-10-11 |
| 1225146954 | Stephen E Mann | Family Medicine | 586 Oak Hill, Williston, VT 05495 | 2006-08-25 |
| 1861418782 | Jeffrey Erik Haddock | Family Medicine | 586 Oak Hill Rd, Williston, VT 05495-7103 | 2006-07-14 |
| 1992793673 | William Curtis Small | Family Medicine | 1213 15th Ave W, Williston, ND 58801-3800 | 2005-10-07 |
| 1437780764 | Chantal Marie Nichols | Family Medicine | 630 N Main St, Williston, FL 32696-1705 | 2020-01-27 |
| 1780220921 | Kristen M Caulder | Family Medicine | 13975 Church St, Williston, SC 29853-5835 | 2019-11-22 |
| 1508352915 | Tyler Greg Egan | Family Medicine | 300a Nw 1st Ave, Williston, FL 32696-2006 | 2018-07-09 |
| 1518457746 | Danielle Jasinski | Family Medicine | 28 Park Ave, Williston, VT 05495-9701 | 2018-05-14 |
| 1508373572 | Family Medicine Partners - Vermont | Family Medicine | 66 Knight Ln Ste 10, Williston, VT 05495-9308 | 2017-12-29 |
| Find all providers in WILLISTON | ||||
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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.