Active NPI
Sushil Kumar Sompur Vasanthkumar, M.D.
- Psychiatry Physician
- Fargo, ND
National Provider Identifier
1356587950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- RL10568
- Practice address
- 1919 Elm St N
Department of Clinical Neuroscience
Fargo, ND 58102-2416 - Phone
- (701) 293-4101
- Fax
- (701) 293-4109
- NPI assigned
- Jan 2, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | RL10568 | ND | Primary |
Addresses
Primary practice location
1919 Elm St N
Department of Clinical Neuroscience
Fargo, ND 58102-2416
Mailing address
1919 Elm St N
Department of Clinical Neuroscience
Fargo, ND 58102-2416
Phone (701) 293-4101
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 |
|---|---|---|---|
| RL10568 | ND | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1230854400000",
"number": "1356587950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1919 ELM ST N",
"address_2": "DEPARTMENT OF CLINICAL NEUROSCIENCE",
"city": "FARGO",
"state": "ND",
"postal_code": "581022416",
"telephone_number": "701-293-4101",
"fax_number": "701-293-4109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 ELM ST N",
"address_2": "DEPARTMENT OF CLINICAL NEUROSCIENCE",
"city": "FARGO",
"state": "ND",
"postal_code": "581022416",
"telephone_number": "701-293-4101",
"fax_number": "701-293-4109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOMPUR VASANTHKUMAR",
"first_name": "SUSHIL KUMAR",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-01-02",
"last_updated": "2009-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "ND",
"license": "RL10568",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.