Shadagopan Saragur Parthasarathy, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305209091 Issued in VA

Practice address

836 Glendale Rd
Galax, VA 24333-2490

Phone

(276) 236-9991

NPI assigned

Jun 15, 2015

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 15, 2015.

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434326400000",
    "number": "1114308111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MADISON ST APT 12",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332942",
            "telephone_number": "909-363-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 GLENDALE RD",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332490",
            "telephone_number": "276-236-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARTHASARATHY",
        "first_name": "SHADAGOPAN",
        "middle_name": "SARAGUR",
        "credential": "D.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305209091",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "037497",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Woodrow Edward Pack Jr.
• Zachary Lee Page, FNP
• Michael Roy Painter
• Byron Clifton Palmer, DDS
• Katrina Bolt Parks, MSN, NP-C
• Pathology Associates of Southwestern Virginia Inc
• Tracy Ann Patton, LPN
• Paul C. Liebrecht, M.D., P.C.
• Peace of Mind Counseling Service
• Arthur Samuel Pemberton, M.D.

• All providers in Galax, VA
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; 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.