Cardinal Psychiatric Consultants LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

DO1185 Issued in SC

Legal business name

CARDINAL PSYCHIATRIC CONSULTANTS LLC

Practice address

125 Alpine Cir
Columbia, SC 29223-6385

Phone

(803) 779-3548

NPI assigned

Mar 28, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Mohan Sridaran, D.O.

Title

Physician

Phone

(919) 810-8056

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346889600000",
    "number": "1194091850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 BURBERRY DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 ALPINE CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236385",
            "telephone_number": "803-779-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDINAL PSYCHIATRIC CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-09-06",
        "status": "A",
        "authorized_official_last_name": "SRIDARAN",
        "authorized_official_first_name": "MOHAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "919-810-8056",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "DO1185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Columbia, SC
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; 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.