Provider Demographics
NPI:1922074467
Name:ANANTH, PERIAPATNA (MD)
Entity Type:Individual
Prefix:DR
First Name:PERIAPATNA
Middle Name:
Last Name:ANANTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 801128
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1128
Mailing Address - Country:US
Mailing Address - Phone:660-827-9528
Mailing Address - Fax:660-827-7691
Practice Address - Street 1:1430 THOMPSON BLVD STE 7
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-2209
Practice Address - Country:US
Practice Address - Phone:660-827-9528
Practice Address - Fax:660-827-7691
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-23070208VP0000X
KS0423070207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO500033298Medicaid
MO52156016OtherBC-KC