SURENDRA KOLLA (NPI# 1194952143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194952143 |
| Entity Type | Individual |
| Full Name | SURENDRA KOLLA |
| Credential | MD |
| Practice Address |
3311 E Murdock St Wichita KS 67208-3054 |
| Practice Telephone | 3166899185 |
| Mailing Telephone | 3166899185 |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2015-07-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 04-37597 | KS | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICAL LICENSE NUMBER | A122586 | 01 |
| Street Address |
3311 E MURDOCK ST |
| City | WICHITA |
| State | KS |
| Zip Code | 67208-3054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811987324 | Bushra Sulieman | Internal Medicine | 3311 E Murdock St, Wichita, KS 67208-3054 | 2005-10-26 |
| 1770057812 | Hannah Roth | Physician Assistant | 3311 E Murdock St, Wichita, KS 67208-3054 | 2019-01-11 |
| 1881167682 | Megan Theresa Poell | Registered Nurse | 3311 E Murdock St, Wichita, KS 67208 | 2019-01-04 |
| 1629552484 | Nichole L Fischer | Nurse Practitioner | 3311 E Murdock St, Wichita, KS 67208-3054 | 2018-09-18 |
| 1215436647 | Joshua Cody Forsberg | Nurse Practitioner | 3311 E Murdock St, Wichita, KS 67208-3054 | 2018-02-12 |
| 1619484540 | Kelsey Olson | Licensed Practical Nurse | 3311 E Murdock St, Wichita, KS 67208-3054 | 2017-12-31 |
| 1174045520 | Genevieve Jo Gutierrez Davis | Nurse Practitioner | 3311 E Murdock St, Wichita, KS 67208-3054 | 2017-07-07 |
| 1013374990 | Ascension Medical Group Via Christi, Pa | Radiology | 3311 E Murdock St, Wichita, KS 67208-3054 | 2016-01-22 |
| 1013372671 | Krista Fischer | Nurse Practitioner | 3311 E Murdock St, Wichita, KS 67208-3054 | 2015-12-28 |
| 1639544992 | Tressie Maugans | Nurse Practitioner | 3311 E Murdock St, Wichita, KS 67208-3054 | 2015-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598316218 | Wesley Urgent Care, LLC | Clinic/Center | 2060 N. Mid Campus Dr., Wichita, KS 67208 | 2019-09-24 |
| 1023574209 | Unified Care Homes, Inc. | Custodial Care Facility | 5705 E Rockhill, Wichita, KS 67208 | 2019-02-13 |
| 1164940730 | Donita Hock | Occupational Therapy Assistant | 622 N. Edgemoor St., Wichita, KS 67208 | 2017-09-05 |
| 1427439546 | Mental Health Association of Sck | Community/Behavioral Health | 555 N Woodlawn, S 3105, Wichita, KS 67208 | 2015-06-15 |
| 1013311430 | Adrian Matta | Occupational Therapy Assistant | 1915 Farmstead Street, Wichita, KS 67208 | 2014-10-14 |
| 1700285343 | Stephanie Kendrick | Physical Therapist | 4921 E. 21st Street North, Wichita, KS 67208 | 2014-08-20 |
| 1689087942 | Apeksha Sathyaprasad | Pediatrics | 3243 E Murdock St Ste 402, Wichita, KS 67208 | 2014-06-04 |
| 1437418019 | J. W, Leisy M.d.p.a. | Psychiatry & Neurology | 3310 East Douglas #101, Wichita, KS 67208 | 2012-05-16 |
| 1184993156 | College Hill-ltc LLC | Skilled Nursing Facility | 5005 East 21st Street North, Wichita, KS 67208 | 2011-12-21 |
| 1255616132 | Thane M Vaneaton | Pharmacist | 3333 East Central, Wichita, KS 67208 | 2011-10-11 |
| Find all providers in zip 67208 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184736118 | Rodney G Handsfield | Urology | 1130 S Clifton Ave, Wichita, KS 67218-2913 | 2006-08-31 |
| 1831118025 | Bibiano Borromeo Ouano Jr. | Urology | 1431 Bluffview St Ste 216, Wichita, KS 67218-3039 | 2006-07-19 |
| 1457319519 | Larry I Frank | Urology | 5500 East Kellogg Dr, Robert J Dole Va Medical Center, Wichita, KS 67218-9937 | 2006-05-01 |
| 1679565337 | John M Donovan | Urology | 3243 E Murdock St Ste 500, Wichita, KS 67208 | 2005-08-18 |
| 1427050079 | Fadi N Joudi | Urology | 2626 N Webb Rd, Wichita, KS 67226-8110 | 2005-08-12 |
| 1760825137 | Jonathan Andrew Jensen | Urology | 2626 N Webb Rd, Wichita, KS 67226-8110 | 2013-04-16 |
| 1760641476 | Clay Earl Lyddane | Urology | 3311 E Murdock St, Wichita, KS 67208-3054 | 2008-06-06 |
| 1083895494 | Christel Orphee Wambi- Kiesse | Urology | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2007-11-14 |
| 1417169889 | The Prostate Treatment Center | Urology | 1130 S Clifton Ave, Wichita, KS 67218-2913 | 2007-05-05 |
| 1508985417 | Tim Alan Richardson | Urology | 2626 N Webb Rd, Wichita, KS 67226-8110 | 2007-03-29 |
| Find all providers in WICHITA | ||||
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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.