Shyamala P C

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

28250 Issued in AZ

Legal business name

SHYAMALA P C

Practice address

6677 W Thunderbird Rd Ste D148
Glendale, AZ 85306-3769

Phone

(602) 843-3811

Fax

(602) 843-0044

NPI assigned

Dec 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Shyamala Kumar, M.D.NPI 1457314841

Title

President

Phone

(602) 999-6342

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shyamala Kumar, MD

  • Neurology Physician
  • Glendale, AZ
  • NPI 1457314841
  Medicare reassignment Authorized official
• Miranda Angermeier, FNP

  • Nurse Practitioner
  • Sun City, AZ
  • NPI 1649949611
  Medicare reassignment NPD

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1255514907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6677 W THUNDERBIRD RD STE D148",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063769",
            "telephone_number": "602-843-3811",
            "fax_number": "602-843-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6677 W THUNDERBIRD RD STE D148",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063769",
            "telephone_number": "602-843-3811",
            "fax_number": "602-843-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHYAMALA P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "SHYAMALA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-999-6342",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "28250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "569353-03",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDCR GROUP BOX 33B",
            "identifier": "Z74891",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Shuey
• Andrew A Shultz, M.D.
• David Shumaker, PHARM D
• Sam Faulkner Shumway, PA
• Justin Jay Shun, MD
• Danielle Justine Sibigtroth, MS, CCC-SLP
• Samuel Sickmeyer, D.C.
• Jemima Siclovan
• Renee Nicole Siddell, M.S., CCC-SLP
• Mary Ellen Sidler, SLP

• Neurology Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Neurology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.