Provider Demographics
NPI:1174521496
Name:NAGAMANI, KEVIN KARTHIK (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:KARTHIK
Last Name:NAGAMANI
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 1:1830 FRANKLIN ST
Mailing Address - Street 2:SUITE 450
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1128
Mailing Address - Country:US
Mailing Address - Phone:303-321-1333
Mailing Address - Fax:303-321-0620
Practice Address - Street 1:1830 FRANKLIN ST
Practice Address - Street 2:SUITE 450
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1128
Practice Address - Country:US
Practice Address - Phone:303-321-1333
Practice Address - Fax:303-321-0620
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44459207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO90424719Medicaid
KS200423190BMedicaid
COP00384799OtherRR MEDICARE PIN
CO90424719Medicaid
COP00384799OtherRR MEDICARE PIN
KS200423190BMedicaid