Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kalugotla N Shivaram, MD

Individual provider Emergency Medicine Physician · NPI 1619959137

Dr. Kalugotla N Shivaram, MD is an Emergency Medicine in Wentzville, Missouri. Qualified in 1989, 37 years ago. Practices with Southeastern Emergency Physicians of Memphis LLC, a 92-clinician group. Licensed in Illinois and Missouri.

Years since qualifying
37
Licensed in
IL, MO
In the registry since
2005
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1111 W Pearce Blvd
Wentzville, MO 63385-1020
Phone: (636) 887-4288
Fax: (636) 639-2368
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 111383 (MO)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 036086751 (IL)
Pediatric Emergency Medicine (Emergency Medicine) Physician Taxonomy 207PP0204X · Licence 111383 (MO)
Pediatrics Physician Taxonomy 208000000X · Licence 111383 (MO)

Record details

NPI number1619959137
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 18, 2005
Last updated in NPPESOctober 6, 2023
Certification dateOctober 6, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Also practisesPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 1989 (37 years in practice)
Group practice Southeastern Emergency Physicians Of Memphis Llc — 92 clinicians
Accepts Medicare assignment Not indicated
Practice locations5 on file with Medicare

Other providers in Wentzville