{"npi":"1164518460","type":"NPI-1","status":"active","name":{"display":"Prasad Kandula M.D.","other":[],"first":"PRASAD","last":"KANDULA","middle":"V","credential":"M.D."},"specialty":{"primary_taxonomy":"207RI0011X","primary_taxonomy_description":"Interventional Cardiology","slug":"interventional-cardiology","schema_org_specialty":"Cardiovascular","all":[{"code":"207UN0901X","description":"Nuclear Cardiology Physician","primary":false,"state":"IL","license":"036086651"},{"code":"207RC0000X","description":"Cardiovascular Disease","primary":false,"state":"IL","license":"036086651"},{"code":"207RI0011X","description":"Interventional Cardiology","primary":true,"state":"IL","license":"036086651"}]},"addresses":[{"purpose":"LOCATION","street_1":"4600 MEMORIAL DR STE W1","city":"BELLEVILLE","state":"IL","postal_code":"622265359","country_code":"US","phone":"6182333066"},{"purpose":"MAILING","street_1":"3 SAINT ELIZABETH BLVD","city":"O FALLON","state":"IL","postal_code":"622691281","country_code":"US","phone":"6182336044","fax":"6182335195"}],"license":{"state":"IL","number":"036086651"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"036086651","state":"IL","issuer":null},{"type_code":"05","label":"Medicaid","value":"1164518460","state":"IL","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20060112000662","type_code":"14-06","type_desc":"PRACTITIONER - CARDIOVASCULAR DISEASE (CARDIOLOGY)","state":"IL","pac_id":"9234152505"}]},"enumeration_date":"2006-10-05","last_updated":"2025-12-29","_meta":{"source":"NPPES","snapshot_date":"2025-12-29","doc_url":"https://findmynpi.com/api"}}