Active NPI
Suneetha Mattegunta, M.D.
- Child & Adolescent Psychiatry Physician
- Goldsboro, NC
National Provider Identifier
1235140682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 200201493
- Practice address
- Cherry Hospital
1401 West Ash Street
Goldsboro, NC 27530-1078 - Phone
- (919) 735-9710
- NPI assigned
- Aug 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 200201493 | NC | Primary |
Addresses
Primary practice location
Cherry Hospital
1401 West Ash Street
Goldsboro, NC 27530-1078
Mailing address
Cherry Hospital
1401 West Ash Street
Goldsboro, NC 27530-1078
Phone (919) 735-9710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110310000258 | NC | Practitioner - Psychiatry | 2860674918 | Practice locations: Goldsboro, NC |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200201493 | NC | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602028800000",
"number": "1235140682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CHERRY HOSPITAL",
"address_2": "1401 WEST ASH STREET",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275301078",
"telephone_number": "919-735-9710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CHERRY HOSPITAL",
"address_2": "1401 WEST ASH STREET",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275301078",
"telephone_number": "919-735-9710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTEGUNTA",
"first_name": "SUNEETHA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2020-10-07",
"certification_date": "2020-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NC",
"license": "200201493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goldsboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.