Organization Active NPI

Ashakiran J. Sunku, M.D., LLC

  • Neurology Physician
  • Pueblo, CO
National Provider Identifier
1063604874
Registry record updated Aug 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
ASHAKIRAN J. SUNKU, M.D., LLC
Practice address
1600 N Grand Ave
Suite: 110
Pueblo, CO 81003-2700
Phone
(719) 546-9500
Fax
(719) 546-9503
NPI assigned
Aug 15, 2007
Last updated
Aug 15, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ashakiran J Sunku, M.D.NPI 1174603005
Title
Owner
Phone
(719) 546-9500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084N0400X Primary
Neurology with Special Qualifications in Child Neurology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084N0402X

Addresses

Primary practice location

1600 N Grand Ave
Suite: 110
Pueblo, CO 81003-2700

Mailing address

1600 N Grand Ave
Suite: 110
Pueblo, CO 81003-2700
Phone (719) 546-9500

Other identifiers 1

IdentifierTypeStateIssuer
04023552MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110913000433 CO Part B Supplier - Clinic/Group Practice 9032380514 Receives reassigned benefits from 1 practitioner
Practice locations: Pueblo, CO

National Provider Directory

National Provider Directory

Locations

1600 N Grand Ave
Ste 110
Pueblo, CO 81003
Phone (719) 543-4000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187136000000",
    "number": "1063604874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE",
            "address_2": "SUITE: 110",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032700",
            "telephone_number": "719-546-9500",
            "fax_number": "719-546-9503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE",
            "address_2": "SUITE: 110",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032700",
            "telephone_number": "719-546-9500",
            "fax_number": "719-546-9503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHAKIRAN J. SUNKU, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-08-15",
        "status": "A",
        "authorized_official_last_name": "SUNKU",
        "authorized_official_first_name": "ASHAKIRAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-546-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04023552",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.