Gowdhami Mohan, MD

Primary specialty

Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X

License

17935 Issued in SC

Practice address

785 Ohio Ave Ste 3E
Clarksdale, MS 38614-6215

Phone

(662) 351-0702

Fax

(662) 351-0703

NPI assigned

Jun 9, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in SC, MS2 enrollments

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 2

Specialty

Sleep MedicineAlso: Pulmonary Disease

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sai Sanjeevani Medical Group LLCGroup PAC ID 5395188858, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Missississippi Regional Medical Center Hospital, Clarksdale, MS, CCN 250042

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Sai Sanjeevani Medical Group LLC

  • Internal Medicine Physician
  • Clarksdale, MS
  • NPI 1871361121
  Medicare reassignment Care Compare group NPD Authorized official
• Northwest Miss Regional Medical Center

  dba NWMRMC OPT Clinics

  • Internal Medicine Physician
  • Clarksdale, MS
  • NPI 1598458515
  Medicare reassignment NPD
• Northwest Miss Regional Medical Center

  dba Northwest Mississippi Regional Medical Center

  • Emergency Medicine Physician
  • Clarksdale, MS
  • NPI 1699468686
  NPD
• Electric City Wellness, LLC

  • Primary Care Nurse Practitioner
  • Anderson, SC
  • NPI 1831814128
  NPD
• Anderson Audiology Consultants, PA

  • Audiologist
  • Anderson, SC
  • NPI 1780723569
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northwest Miss Regional Medical Center

  dba Northwest Mississippi Regional Medical Center

  • General Acute Care Hospital
  • Clarksdale, MS
  • NPI 1275217606
  Care Compare affiliation

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1114921806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 OHIO AVE STE 3E",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386146215",
            "telephone_number": "662-351-0702",
            "fax_number": "662-351-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 OHIO AVE STE 3E",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386146215",
            "telephone_number": "662-351-0702",
            "fax_number": "662-351-0703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1403 E Greenville St",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "SC",
            "postal_code": "296212049",
            "country_code": "US",
            "telephone_number": "864-222-3000",
            "fax_number": "864-437-8799",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "905 W Greenwood St",
            "address_purpose": "LOCATION",
            "city": "Abbeville",
            "state": "SC",
            "postal_code": "296205678",
            "country_code": "US",
            "telephone_number": "864-366-1714",
            "fax_number": "864-437-8799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHAN",
        "first_name": "GOWDHAMI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-09",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "17935",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "SC",
            "license": "17935",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "SC",
            "license": "17935",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "SC",
            "license": "17935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "8607",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T20901",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00944908",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "050001919C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200011416",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonjia Marie Miller, SW
• Mississippi Emergency Physician Services, LLC
• Mississippi State Department of Health
• Connie Mitchell, MSW
• MJC Dental, PLLC (Crossroads Family Dentistry)
• Rolanda Mohead, MSW, CMHT
• Arlena Francisco Moore, M.ED.
• Camila A Moore, M.ED.
• Lashea R Moore
• Lukesha Shonnet Morris

• Sleep Medicine (Internal Medicine) Physician in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• Sleep Medicine (Internal Medicine) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.