DR. PRASHANTH PODARALLA (NPI# 1730226952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730226952 |
| Entity Type | Individual |
| Full Name | DR. PRASHANTH PODARALLA |
| Credential | M.D. |
| Practice Address |
100 Medical Dr Hannibal MO 63401-6877 |
| Practice Telephone | 5732313798 |
| Practice Fax Number | 5732313827 |
| Mailing Telephone | 5732313798 |
| Mailing Fax Number | 5732313827 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2014-01-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 2006017617 | MO | Allopathic & Osteopathic Physicians |
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
2006017617 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MEDICARE | 137720019 | 01 |
| MO | 1730226952 | 05 |
| Street Address |
100 MEDICAL DR |
| City | HANNIBAL |
| State | MO |
| Zip Code | 63401-6877 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841299161 | Bryson Roy Mchardy Jr. | Pediatrics | 100 Medical Dr, Hannibal, MO 63401-6877 | 2005-07-19 |
| 1164023644 | Kelli Eagan | Nurse Practitioner | 100 Medical Dr, Hannibal, MO 63401-6877 | 2020-11-02 |
| 1174002232 | Stacy L Johnson | Nurse Practitioner | 100 Medical Dr, Hannibal, MO 63401-6877 | 2018-08-09 |
| 1770096513 | Jennifer Sue Myers | Nurse Practitioner | 100 Medical Dr, Hannibal, MO 63401-6877 | 2017-11-15 |
| 1629581947 | Mitzi Buckman | Nurse Practitioner | 100 Medical Dr, Hannibal, MO 63401-6877 | 2017-11-08 |
| 1568975183 | Kristin Bradshaw | Nurse Practitioner | 100 Medical Dr, Hannibal, MO 63401-6877 | 2017-11-06 |
| 1902316607 | Patsy J Hudson | Nurse Practitioner | 100 Medical Dr, Hannibal, MO 63401-6877 | 2017-10-07 |
| 1164959862 | Alexis Niemann Kirner | Audiologist | 100 Medical Dr, Hannibal, MO 63401 | 2017-05-12 |
| 1477914885 | Janae Suzann Robertson | Nurse Practitioner | 100 Medical Dr, Hannibal, MO 63401-6877 | 2016-03-11 |
| 1942668819 | Lauren N. Brandenburger | Nurse Practitioner | 100 Medical Dr, Hannibal, MO 63401-6877 | 2016-02-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255981064 | Amanda Lynn Jennings | Nurse Practitioner | Hannibal Clinic, 100 Medical Drive, Hannibal, MO 63401 | 2019-09-13 |
| 1316452295 | Hannibal Regional Healthcare System, Inc | Hospice Care, Community Based | 6401 Hwy Mm, Hannibal, MO 63401 | 2017-12-13 |
| 1932614351 | Sidney M Johnson | Counselor | 1221 Broadway St, Hannibal, MO 63401 | 2017-12-07 |
| 1316467210 | Jessica Baker | Counselor | 4355 Paris Gravel Road, Hannibal, MO 63401 | 2017-06-21 |
| 1346787066 | Hands Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17 Settlerstrail, Hannibal, MO 63401 | 2017-01-20 |
| 1134571672 | Pamela Barrigar | Social Worker | 4600 Mcmasters Ave, Hannibal, MO 63401 | 2016-07-08 |
| 1639540677 | Jessica Murfin | Speech-Language Pathologist | 544 N Veterans Rd, Hannibal, MO 63401 | 2015-10-16 |
| 1366835639 | Cpo Services, Inc. | Prosthetic/Orthotic Supplier | 8965 Highway 36 Ste 3, Hannibal, MO 63401 | 2015-03-11 |
| 1639324254 | Hannibal Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 118 Steam Boat Bend, Hannibal, MO 63401 | 2008-11-24 |
| 1780856112 | Barbara Belle Smith | Social Worker | 3700 Hwy Mm, Hannibal, MO 63401 | 2008-03-26 |
| Find all providers in zip 63401 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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 |
|---|---|---|---|---|
| 1811549389 | Sana Hasan | Internal Medicine | Ce 422, One Hospital Drive University of Missouri, Columbia, MO 65212-0001 | 2019-07-15 |
| 1295291409 | Zeeshan Azeem | Internal Medicine | 1 Hospital Drive University Hospital, Columbia, MO 65212-0001 | 2019-02-12 |
| 1932614153 | Mohammad Walid Abuzeineh | Internal Medicine | 1 Hospital Drive Department of Nephrology, Columbia, MO 65211-0001 | 2017-12-11 |
| 1548788896 | Nephrology Care of St Louis | Internal Medicine | 224 S Woods Mill Rd Ste 460, Chesterfield, MO 63017-3513 | 2017-09-07 |
| 1033649819 | Taewoo Lee | Internal Medicine | 3635 Vista Ave Saint Louis University Medical Center, Division of Nephrology, Saint Louis, MO 63110 | 2017-06-14 |
| 1528502978 | Bill Lauderdale | Internal Medicine | 288 State Hwy Y, Forsyth, MO 65653-0010 | 2016-12-05 |
| 1780058727 | St Louis Kidney Care LLC | Internal Medicine | 11155 Dunn Rd Ste 211n, Saint Louis, MO 63136-6166 | 2015-11-13 |
| 1104239888 | Sadaf Sheikh | Internal Medicine | 222 S Woods Mill Rd Ste 750n, Chesterfield, MO 63017-3653 | 2014-06-10 |
| 1225441538 | Tomonori Alan Oyadomari | Internal Medicine | 1009 W Saint Maartens Dr Ste F, Saint Joseph, MO 64506-2990 | 2014-06-04 |
| 1184056830 | Ralph Robert Hatlelid | Internal Medicine | 318 E Swon Ave, Saint Louis, MO 63119-3112 | 2013-08-05 |
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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.