JAGANNADHARAO BRAHMAMDAM (NPI# 1457386922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457386922 |
| Entity Type | Individual |
| Full Name | JAGANNADHARAO BRAHMAMDAM |
| Credential | MD |
| Practice Address |
812 N Logan Ave Danville IL 61832-3752 |
| Practice Telephone | 2174318413 |
| Practice Fax Number | 2174311397 |
| Mailing Telephone | 2174318413 |
| Mailing Fax Number | 2174311397 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2012-10-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
03606004 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200108180 | 05 | |
| IL | 0360600041 | 05 |
| Street Address |
812 N LOGAN AVE |
| City | DANVILLE |
| State | IL |
| Zip Code | 61832-3752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770585267 | Damon C. Green | Anesthesiology | 812 N Logan Ave, Anesthesia, Danville, IL 61832-3752 | 2005-08-15 |
| 1649884354 | Arianna Alexis Watson | Dietitian, Registered | 812 N Logan Ave, Danville, IL 61832-3752 | 2020-09-01 |
| 1821601618 | Rachel Cooper | Dietitian, Registered | 812 N Logan Ave, Danville, IL 61832-3752 | 2020-08-31 |
| 1730738543 | Valorie Lea Mcmillan | Nurse Practitioner | 812 N Logan Ave, Danville, IL 61832-3752 | 2019-09-05 |
| 1669934865 | Lacey J Youhas | Nurse Practitioner | 812 N Logan Ave, Danville, IL 61832-3752 | 2019-04-05 |
| 1003370990 | Randi M Morgan | Nurse Practitioner | 812 N Logan Ave, Danville, IL 61832-3752 | 2019-01-25 |
| 1467921627 | Carter Kenny Mcgowen | Physician Assistant | 812 N Logan Ave, Danville, IL 61832-3752 | 2018-11-17 |
| 1720557341 | Courtney M. Montel | Nurse Practitioner | 812 N Logan Ave, Danville, IL 61832-3752 | 2018-11-14 |
| 1841770534 | Le Ann Galbraith | Nurse Practitioner | 812 N Logan Ave, Danville, IL 61832-3752 | 2018-08-21 |
| 1750875340 | Nicole Marie Gowan | Nurse Practitioner | 812 N Logan Ave, Danville, IL 61832-3752 | 2018-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316593957 | Margaret Jean Heath | Technician | 310 N North St, Danville, IL 61832 | 2019-08-09 |
| 1215494620 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 3653 N Vermilion Dr, Danville, IL 61832 | 2019-02-22 |
| 1003263104 | Bayview Family Clinic | Nurse Practitioner | 3595 N Vermillion Street, Danville, IL 61832 | 2016-05-18 |
| 1194179499 | Kinisha Vasser | Social Worker | 1900 E. Main Steet, Danville, IL 61832 | 2016-04-22 |
| 1023497237 | Alpha Omega Counseling Services | Community/Behavioral Health | 120 N Vermilion, Danville, IL 61832 | 2015-05-20 |
| 1437557568 | Terri D. Dunn | Hearing Instrument Specialist | 733 N. Logan #4, Audibel Hearing Aids, Danville, IL 61832 | 2014-12-05 |
| 1518361682 | Rosemarie Renee Eck | Nurse Practitioner | 1900 E Main St, Bldg 101-171, Va Illiana Health Care System, Danville, IL 61832 | 2014-10-17 |
| 1497181747 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 3649 N. Vermillion St., Danville, IL 61832 | 2013-09-18 |
| 1598000770 | Bayview Family Clinic Ltd | Health Maintenance Organization | 405 N. Sheridan St., Danville, IL 61832 | 2012-11-29 |
| 1992052666 | Katharine Lorraine Lerner | Pharmacist | 3649 N Vermilion St, Danville, IL 61832 | 2012-08-13 |
| Find all providers in zip 61832 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114245990 | John Cho | Radiology | 105 Ridgeview, Danville, PA 17821-8435 | 2010-05-04 |
| 1902049513 | Central Kentucky Radiology | Radiology | 124 Daniel Dr, Danville, KY 40422-2527 | 2009-04-13 |
| 1831119254 | Richard Keith Hollis | Radiology | 692 Rocky Knoll Ln, Danville, VA 24541-8932 | 2006-07-20 |
| 1255356820 | United Radiology Service | Radiology | 812 North Logan Avenue, Danville, IL 61832 | 2006-07-13 |
| 1548226186 | Laurence John Soges | Radiology | Geisinger Medical Center, Dept Radiology, 100 N Academy Ave, Danville, PA 17822-0001 | 2006-04-22 |
| 1528038692 | Henry Huson II | Radiology | 288 W Main St, Danville, VA 24541-2848 | 2006-01-23 |
| 1538149448 | Douglas R May | Radiology | 142 S Main St, Danville, VA 24541-2922 | 2006-01-18 |
| 1205446390 | Dm Radiology LLC | Radiology | 304 Virginia Ave, Danville, VA 24541-3730 | 2020-08-04 |
| 1578983557 | Thomas Nevers | Radiology | 100 N Academy Ave, Danville, PA 17822-3628 | 2014-04-17 |
| 1932548567 | Joshua Nicholas Pitzen | Radiology | 100 N Academy Ave, Danville, PA 17822-0001 | 2013-06-17 |
| Find all providers in DANVILLE | ||||
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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.