Organization Active NPI

Vellaiappan Somasundaram M.D. PLLC

  • Primary Care Clinic/Center
  • South Williamson, KY
National Provider Identifier
1063617173
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
35436 Issued in KY
Legal business name
VELLAIAPPAN SOMASUNDARAM M.D. PLLC
Practice address
306 Hospital Dr Ste 202C
South Williamson, KY 41503-4096
Phone
(606) 237-5800
Fax
(606) 237-5858
NPI assigned
Jun 19, 2007
Last updated
Apr 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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

Authorized official

Name
Dr. Vellaiappan Somasundaram, M.D.
Title
Owner
Phone
(606) 237-5800

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 35436 KY Primary
Family Nurse Practitioner 363LF0000X 3567P KY
Internal Medicine Physician 207R00000X 35436 KY

Addresses

Primary practice location

306 Hospital Dr Ste 202C
South Williamson, KY 41503-4096

Mailing address

306 Hospital Dr Ste 202C
South Williamson, KY 41503-4096
Phone (606) 237-5800

Other identifiers 3

IdentifierTypeStateIssuer
600592001MedicaidWV
1891745386OtherKYINDIVIDUAL NPI
64013253MedicaidKY

National Provider Directory

National Provider Directory

Locations

306 Hospital Dr
#202C
South Williamson, KY 41503
Phone (606) 237-5800

Practitioners & affiliated clinicians

Practitioners 1

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": "1182211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272499200000",
    "number": "1063617173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 HOSPITAL DR STE 202C",
            "city": "SOUTH WILLIAMSON",
            "state": "KY",
            "postal_code": "415034096",
            "telephone_number": "606-237-5800",
            "fax_number": "606-237-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 HOSPITAL DR STE 202C",
            "city": "SOUTH WILLIAMSON",
            "state": "KY",
            "postal_code": "415034096",
            "telephone_number": "606-237-5800",
            "fax_number": "606-237-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VELLAIAPPAN SOMASUNDARAM M.D. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-19",
        "last_updated": "2010-04-29",
        "status": "A",
        "authorized_official_last_name": "SOMASUNDARAM",
        "authorized_official_first_name": "VELLAIAPPAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-237-5800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "KY",
            "license": "35436",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3567P",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "35436",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600592001",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1891745386",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64013253",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Williamson, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.