NPIMap

Individual provider Active NPI

Sowmya Srimanthula, MD

  • Internal Medicine Physician
  • South Boston, VA
National Provider Identifier
1174019996
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101274781 Issued in VA
Practice address
101 Aubreys Loop
South Boston, VA 24592-5054
Phone
(434) 517-3879
NPI assigned
Jul 4, 2018
Last updated
Jan 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 33899 OK
Internal Medicine Physician 207R00000X 0101274781 VA Primary

Addresses

Primary practice location

101 Aubreys Loop
South Boston, VA 24592-5054

Mailing address

101 Aubreys Loop
South Boston, VA 24592-5054
Phone (434) 517-3879

Other practice location 1

1200 Childrens Ave # 14000
Oklahoma City, OK 73104-4637
Phone (405) 271-4417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220627000547 VA Practitioner - Internal Medicine 7911386651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Halifax Regional Hospital IncGroup PAC ID 4587572805, 27 clinicians

Practice addresses (Care Compare)

101 Aubreys Loop
South Boston, VA 24592-5054
Phone (434) 517-3879

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33899OKMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Halifax Regional Hospital, Inc CurrentSince Jul 11, 2022 Accepting new patients
Halifax Regional Hospital, Inc. CurrentSince Jul 11, 2022 Accepting new patients

Locations

101 Aubreys Loop
South Boston, VA 24592
Phone (434) 517-3879

2204 Wilborn Ave
South Boston, VA 24592
Phone (434) 517-3100

Interoperability endpoints

  • Direct secure messaging: ssrimanthula766029@direct.sentara.net

Organizations & group practices 2

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1530662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1174019996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 AUBREYS LOOP",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245925054",
            "telephone_number": "434-517-3879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 AUBREYS LOOP",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245925054",
            "telephone_number": "434-517-3879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Childrens Ave # 14000",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731044637",
            "country_code": "US",
            "telephone_number": "405-271-4417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SRIMANTHULA",
        "first_name": "SOWMYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-04",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": "33899",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101274781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, VA

Sources for this page

Verify at the official NPI Registry.