Individual provider Active NPI

Sudershan Kumar Hooda, MD

  • Cardiovascular Disease Physician
  • Milledgeville, GA
National Provider Identifier
1154424604
Registry record updated Jan 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
021521 Issued in GA
Practice address
511 N Cobb St
Suite 13
Milledgeville, GA 31061
Phone
(478) 453-9472
Fax
(478) 453-3134
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 021521 GA Primary

Addresses

Primary practice location

511 N Cobb St
Suite 13
Milledgeville, GA 31061

Mailing address

511 N Cobb St
Suite 13
Milledgeville, GA 31061
Phone (478) 453-9472

Other identifiers 1

IdentifierTypeStateIssuer
000209822BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199750400000",
    "number": "1154424604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 N COBB ST",
            "address_2": "SUITE 13",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "31061",
            "telephone_number": "478-453-9472",
            "fax_number": "478-453-3134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 N COBB ST",
            "address_2": "SUITE 13",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "31061",
            "telephone_number": "478-453-9472",
            "fax_number": "478-453-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOODA",
        "first_name": "SUDERSHAN",
        "middle_name": "KUMAR",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2008-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "021521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000209822B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milledgeville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; 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.