Active NPI
Trishna Sisodraker, M.D.
- Pediatrics Physician
- Ocean Springs, MS
National Provider Identifier
1275945271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 24064
- Practice address
- 3650 Groveland Rd
Ocean Springs, MS 39564-5754 - Phone
- (228) 875-0780
- NPI assigned
- May 24, 2014
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 24064 | MS | Primary |
Addresses
Primary practice location
3650 Groveland Rd
Ocean Springs, MS 39564-5754
Mailing address
3650 Groveland Rd
Ocean Springs, MS 39564-5754
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24064 | MS | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452729600000",
"number": "1275945271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3650 GROVELAND RD",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "395645754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3650 GROVELAND RD",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "395645754",
"telephone_number": "228-875-0780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISODRAKER",
"first_name": "TRISHNA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-24",
"last_updated": "2016-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MS",
"license": "24064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ocean Springs, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.