Individual provider Active NPI

Sonia Ann Varghese, MD MPH MBA

  • Neurology with Special Qualifications in Child Neurology Physician
  • Wilmington, NC
National Provider Identifier
1336674357
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
2022-02399 Issued in NC
Practice address
510 Carolina Bay Dr Ste 200
Wilmington, NC 28403-2046
Phone
(910) 662-8888
Fax
(910) 662-8906
NPI assigned
Apr 27, 2017
Last updated
Mar 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 228185 NC
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 2022-02399 NC Primary

Addresses

Primary practice location

510 Carolina Bay Dr Ste 200
Wilmington, NC 28403-2046

Mailing address

7031 Villa Mountain LN
Spring, TX 77379
Phone (832) 490-7763

Other practice location 1

7031 Villa Mountain Ln
Spring, TX 77379
Phone (832) 490-7763

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240213004014 NC Practitioner - Neurology 0446524797 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2022-02399NCMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group Coastal Region, LLC CurrentSince Jul 31, 2023 Accepting new patients
NMG Health Services LLC CurrentSince Jul 31, 2023 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
New Hanover Medical Group PA Past Accepting new patients

Locations

2000 Brabham Ave
Jacksonville, NC 28546
Phone (910) 662-8765

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

510 Carolina Bay Dr
Ste 200
Wilmington, NC 28403
Phone (910) 662-8888

Interoperability endpoints

  • Direct secure messaging: svarghese1459758@direct.novanthealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1336674357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7031 VILLA MOUNTAIN LN",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "77379",
            "telephone_number": "832-490-7763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 CAROLINA BAY DR STE 200",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032046",
            "telephone_number": "910-662-8888",
            "fax_number": "910-662-8906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7031 Villa Mountain Ln",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "77379",
            "country_code": "US",
            "telephone_number": "832-490-7763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "SONIA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD MPH MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "228185",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NC",
            "license": "2022-02399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.