{"npi":"1124013552","type":"NPI-1","status":"active","name":{"display":"Ravi Konidala MD","other":[],"first":"RAVI","last":"KONIDALA","credential":"MD"},"specialty":{"primary_taxonomy":"207Q00000X","primary_taxonomy_description":"Family Medicine","slug":"family-medicine","schema_org_specialty":"PrimaryCare","all":[{"code":"207QG0300X","description":"Family Medicine, Geriatric Medicine","primary":false,"state":"TX","license":"M6981"},{"code":"207Q00000X","description":"Family Medicine","primary":true,"state":"TX","license":"M6981"}]},"addresses":[{"purpose":"LOCATION","street_1":"1050 E LOOP 304","city":"CROCKETT","state":"TX","postal_code":"758351814","country_code":"US","street_2":"SUITE 200, ETMC RURAL HEALTH CLINIC","phone":"9365445132","fax":"9365448029"},{"purpose":"MAILING","street_1":"511 HEATH ST","city":"CROCKETT","state":"TX","postal_code":"758352290","country_code":"US","phone":"9362040600","fax":"9365448029"}],"license":{"state":"TX","number":"M6981"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"1010424560001","state":"PA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20071003000750","type_code":"14-08","type_desc":"PRACTITIONER - FAMILY PRACTICE","state":"TX","pac_id":"1557331758"}]},"enumeration_date":"2005-09-12","last_updated":"2011-06-02","_meta":{"source":"NPPES","snapshot_date":"2011-06-02","doc_url":"https://findmynpi.com/api"}}