Healthcare Provider Details

I. General information

NPI: 1538366448
Provider Name (Legal Business Name): RANI NAIR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RANI RADHAMMA MD

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 02/09/2021
Certification Date: 02/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3231 S NATIONAL MERCY ENDOCRINEOLOGY STE 440
SPRINGFIELD MO
65810
US

IV. Provider business mailing address

3231 S NATIONAL MERCY ENDOCRINOLOGY 6446 S VALLEY BROOK CT
SPRINGFIELD MO
65810
US

V. Phone/Fax

Practice location:
  • Phone: 417-888-5680
  • Fax: 417-888-6793
Mailing address:
  • Phone: 314-308-1320
  • Fax: 417-888-6793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMO2007028027
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMO2007028027
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: