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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

PRITHVI BOMDICA, MD

Deactivated

PRITHVI BOMDICA, MD is a Sports Medicine (Emergency) healthcare provider located in BRENTWOOD, Missouri. NPI 1699149500 is deactivated in the NPPES registry. Verify at CMS.

Sports Medicine (Emergency) · BRENTWOOD, MO

This NPI has been deactivated. The record was deactivated on May 15, 2020. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1699149500
Provider Type
Individual
Gender
Male
NPI Issued
Nov 17, 2015 (4.4918032786885 yrs)
Last Updated
Sep 3, 2024
Deactivated
May 15, 2020
Licenses
2024016762 (MO)
036168884 (IL)

Practice Information

Address
1600 S BRENTWOOD BLVD STE 700
BRENTWOOD, MO, 631441304
Browse MO providers · Browse ZIP 63144
Phone
3143671181
Primary Specialty
Sports Medicine (Emergency)
207WX0107X
Additional Specialty
Sports Medicine (Emergency)

Other Sports Medicine (Emergency) Providers in BRENTWOOD, MO

Name Credential NPI
DR. KEVIN J BLINDER MD 1669476560
DR. NICHOLAS ENGELBRECHT MD 1891791844
RICHARD JOSEPH ROTHMAN MD 1508867318
THOMAS K KRUMMENACHER MD 1205837978
DR. BRADLEY THOMAS SMITH MD 1588608970
DR. ATHANASIOS PAPAKOSTAS MD 1588975346
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.