Mecheri Sundaram, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

13713 Issued in MS

Practice address

2500 North State Street
Jackson, MS 39216

Phone

(601) 984-5500

Fax

(601) 984-5499

NPI assigned

Jul 28, 2006

Last updated

May 3, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• Mississippi Methodist Hospital & Rehabilitation Center, Inc.

  dba Methodist Rehab Center

  • Physical Medicine & Rehabilitation Physician
  • Jackson, MS
  • NPI 1790711273
  NPD (past)
• Ms Methodist Hospital & Rehabilitation Center

  dba Methodist Rehab Ceter

  • Clinical Neuropsychologist
  • Jackson, MS
  • NPI 1285772293

  Neurology

  NPD (past)
• University Neurology Group, PLLC

  • Neurology Physician
  • Jackson, MS
  • NPI 1770599110
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1073527743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500N STATE ST",
            "address_2": "JMM ROOM 2525",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-6426",
            "fax_number": "601-984-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-984-5500",
            "fax_number": "601-984-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDARAM",
        "first_name": "MECHERI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MS",
            "license": "13713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0112950",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00620822",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summit Counseling
• Caryl P. Sumrall, FNP
• Judith Patterson Sumrall
• Lauren Nicole Sumrall
• Sunbelt Enterprises of Mississippi Inc
• Sunny Days at Home Healthcare, LLC
• Sunny Seas Medical Supplies, LLC
• Sunrise Prosthetics and Orthotics
• Super D Drugs Acquisition Co (Super D Drugs)
• Super D Drugs Acquisition Co (Super D Drugs)

• Neurology Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Neurology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.