Shirani Damayanthi Wijay-Samarasinha, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301041041 Issued in MI

Practice address

5829 S Westnedge Ave
Portage, MI 49002-1456

Phone

(269) 343-4700

Fax

(269) 343-3002

NPI assigned

Jul 8, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245263623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1626",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490811626",
            "telephone_number": "269-343-4700",
            "fax_number": "269-343-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5829 S WESTNEDGE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021456",
            "telephone_number": "269-343-4700",
            "fax_number": "269-343-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIJAY-SAMARASINHA",
        "first_name": "SHIRANI",
        "middle_name": "DAMAYANTHI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301041041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Whitelow
• Chitradevi CC Widen, LMFT; LPC
• Jeffrey Edward Wiederhold, D.C.
• Sandra Wiederhold, MD
• Barbara Wiedmayer
• Kim Wikel
• Chloe Wilcox
• Kari Wilcox, M.A., LPC/LLP
• Barton William Wild, MD
• Kari Joy Wildner, LCSW

• Internal Medicine Physician in Portage, MI
• Providers in Portage, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.