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FOUR CORNERS INTERNAL MEDICINE, LLC
NPI 1346295466
Clinic/Center in Davenport, FL

Active since May 24, 2006
106 POLO PARK EAST BLVD, DAVENPORT, FL 33897(863) 424-8900(863) 424-8823 Get Directions Write a Review

NPPES record last updated: October 20, 2010. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Four Corners Internal Medicine, Llc NPPES

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

FOUR CORNERS INTERNAL MEDICINE, LLC (NPI 1346295466) is a healthcare organization registered as a clinic/center in Davenport, Florida and active in the NPI registry since May 2006. The organization lists Srinath Reddy Kosanam, Owner, as its authorized official.

NPPES Registry Identity

NPI1346295466
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameFOUR CORNERS INTERNAL MEDICINE, LLC
Location Address106 POLO PARK EAST BLVDDavenport, FL 33897-9407
Mailing Address10603 Emerald Chase DrOrlando, FL 32836-5855 · (407) 217-5353 · Fax (407) 217-5353
Phone(863) 424-8900
Fax(863) 424-8823
Organization SubpartNo
Authorized OfficialSrinath Reddy KosanamOwner · (863) 424-8900
Enumeration DateMay 24, 2006
Last NPPES UpdateOctober 20, 2010
✔ NPI 1346295466 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in FL · ME78339
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
106 POLO PARK EAST BLVD, Davenport, FL 33897
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Other Identifiers 1

Medicare PINK9842

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Four Corners Internal Medicine, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Four Corners Internal Medicine, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Srinath Kosanam, M.D
Internal Medicine
NPI 1154313476
106 POLO PARK EAST BLVD
Davenport, FL 33897
(863) 424-8900
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Four Corners Internal Medicine, LLC's NPI number?

The NPI number for Four Corners Internal Medicine, LLC is 1346295466. It was assigned to this organization in the NPPES registry on May 24, 2006.

Where is Four Corners Internal Medicine, LLC located?

Four Corners Internal Medicine, LLC is located at 106 Polo Park East Blvd, Davenport, FL 33897. The listed phone number is (863) 424-8900.

What is Four Corners Internal Medicine, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Four Corners Internal Medicine, LLC enrolled in Medicare?

Yes. Four Corners Internal Medicine, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Four Corners Internal Medicine, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Four Corners Internal Medicine, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Four Corners Internal Medicine, LLC was last updated on October 20, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.