Dr. Kalugotla N Shivaram
MD | Pediatrics | Male
Dr. Kalugotla N Shivaram, MD is a Wentzville, Missouri based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Dr. Kalugotla N Shivaram is
1111 W Pearce Blvd, Wentzville, Missouri - 63385-1020. He can be contacted on phone at
636-887-4288 and fax number 636-639-2368.
Dr. Kalugotla N Shivaram is a sole proprietor of his business.
NPI number (Unique professional ID) for Dr. Kalugotla N Shivaram is
1619959137 which was assigned by NPPES on 18 Nov, 2005 and it was last updated on 30 Aug, 2022.
Dr. Kalugotla N Shivaram license number is
111383 for Pediatrics (208000000X) in Missouri.
Dr. Kalugotla N Shivaram is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Dr. Kalugotla N Shivaram basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Dr. Kalugotla N Shivaram |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Dr. Kalugotla N Shivaram address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 1111 W Pearce Blvd
Wentzville, MO, 63385-1020
United States |
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| Phone Number : | 636-887-4288 |
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| Fax Number : | 636-639-2368 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1619959137 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 18 Nov, 2005 |
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| Last Updated On : | 30 Aug, 2022 |
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Medicare Participation:
Dr. Kalugotla N Shivaram participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.
| Medicare PECOS ID : | 6103850797 |
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| Medicare Enrollment ID : | I20051005001009 |
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| Primary Specialty : | Emergency Medicine |
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| Medical School : | Other |
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| Graduation Year : | 1989 |
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| Accepts Medicare? | Yes. Dr. Kalugotla N Shivaram accepts medicare insurance. |
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Group Practice Association:
Dr. Kalugotla N Shivaram is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Dr. Kalugotla N Shivaram is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.
| Organisation Name : | Group Practice ID | No. of Members | Practice Address | Group Accepts Medicare |
|---|
| Southeastern Emergency Physicians Of Memphis Llc | 5395643209 | 77 | 1 Memorial Dr
Alton, IL - 620026722
Ph: 6184637311 | Yes |
| Alton-griffin Emergency Group Pc | 7315167103 | 11 | 1 Saint Anthonys Way
Alton, IL - 620024568
Ph: 6184652571 | Yes |
| Potosi Emergency Group, Llc | 0648588541 | 16 | 300 Health Way Dr
Potosi, MO - 636641420
Ph: 5734385451 | Yes |
| Southeastern Emergency Physicians Of Memphis Llc | 5395643209 | 77 | 1600 E Broadway
Columbia, MO - 652015897
Ph: 5738754545 | Yes |
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Kalugotla N Shivaram are as mentioned. Primary taxonomy code for Dr. Kalugotla N Shivaram, MD is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 207P00000X | Emergency Medicine | No | 036086751 | IL |
| 207P00000X | Emergency Medicine | No | 111383 | MO |
| 207PP0204X | Emergency Medicine | No | 111383 | MO |
| 208000000X | Pediatrics | Yes | 111383 | MO |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Kalugotla N Shivaram such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| 003014740 | MEDICARE PIN | MO | |
| 003014748 | MEDICARE PIN | MO | |
| 003015009 | MEDICARE PIN | MO | |
| 003015439 | MEDICARE PIN | MO | |
| 036086751 | MEDICAID | IL | |
| 1619959137 | MEDICARE PIN | MO | |
| 207245606 | MEDICAID | MO | |
| G10371 | MEDICARE UPIN | MO | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 842 Bellerive Manor Dr
Creve Coeur, MO, 63141-3201
United States |
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| Phone Number : | 636-887-4288 |
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Business Location:
Patients can refer following map for directions to
Dr. Kalugotla N Shivaram practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.