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GORANTLA GOVINDAIAH, M.D., S.C.
NPI 1023222502
Clinic/Center - Health Service in East Moline, IL

Active since May 10, 2007
4366 KENNEDY DR, SUITE B, EAST MOLINE, IL 61244(309) 796-1510(309) 796-1565 Get Directions Write a Review

NPPES record last updated: May 15, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Gorantla Govindaiah, M.d., S.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GORANTLA GOVINDAIAH, M.D., S.C. (NPI 1023222502) is a healthcare organization registered as a health service in East Moline, Illinois and active in the NPI registry since May 2007. The organization lists Gorantla Govindaiah, Owner, as its authorized official.

NPPES Registry Identity

NPI1023222502
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NameGORANTLA GOVINDAIAH, M.D., S.C.
Location Address4366 KENNEDY DR, SUITE BEast Moline, IL 61244-4288
Mailing Address4366 Kennedy Dr, Suite BEast Moline, IL 61244-4288 · (309) 796-1510 · Fax (309) 796-1565
Phone(309) 796-1510
Fax(309) 796-1565
Organization SubpartNo
Authorized OfficialGorantla GovindaiahOwner · (309) 796-1510
Enumeration DateMay 10, 2007
Last NPPES UpdateMay 15, 2008
✔ NPI 1023222502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
4366 KENNEDY DR, East Moline, IL 61244
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Other Identifiers 7

Other98669IA · Wellmark Bcbs
Medicare UPINC38530IL
Other010063712Rr Medicare
Medicaid036049003IL
Other263500IL · Medicare Group
Other8100279IL · Bcbs
OtherK44585IL · Medicare Individual

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMBER SPIVA BCBA
Behavior Analyst
4366 KENNEDY DR
EAST MOLINE, IL 61244
Rock Island County (630) 759-0201
INDIVIDUAL ADVOCACY GROUP
Clinic/Center (Adult Mental Health)
4366 KENNEDY DR
EAST MOLINE, IL 61244
Rock Island County (309) 796-1603
AGRA VINAUDE LPC
Counselor (Professional)
4366 KENNEDY DR
EAST MOLINE, IL 61244
Rock Island County (309) 796-1603
SUJATHA GOVINDAIAH, M.D., S.C.
Clinic/Center (Adult Mental Health)
4366 KENNEDY DR, SUITE A
EAST MOLINE, IL 61244
Rock Island County (309) 796-1512
JUDITH ANN AUGSBURGER LCPC
Counselor (Professional)
4366 KENNEDY DR
EAST MOLINE, IL 61244
Rock Island County (309) 796-1603

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gorantla Govindaiah, M.D., S.C.'s NPI number?

The NPI number for Gorantla Govindaiah, M.D., S.C. is 1023222502. It was assigned to this organization in the NPPES registry on May 10, 2007.

Where is Gorantla Govindaiah, M.D., S.C. located?

Gorantla Govindaiah, M.D., S.C. is located at 4366 Kennedy Dr Suite B, East Moline, IL 61244. The listed phone number is (309) 796-1510.

What is Gorantla Govindaiah, M.D., S.C.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

When was this NPI record last updated?

The NPPES record for Gorantla Govindaiah, M.D., S.C. was last updated on May 15, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.