Active NPI
Katapadi Surendra Shenoy, M.D.
- Nephrology Physician
- Port Royal, SC
National Provider Identifier
1376550582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 11315
- Practice address
- 1859 North Paris Avenue
Suite 212
Port Royal, SC 29935-2047 - Phone
- (843) 524-2002
- Fax
- (843) 524-3522
- NPI assigned
- Aug 1, 2006
- 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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 11315 | SC | Primary |
Addresses
Primary practice location
1859 North Paris Avenue
Suite 212
Port Royal, SC 29935-2047
Mailing address
1859 North Paris Avenue
Suite 212
Port Royal, SC 29935-2047
Phone (843) 524-2002
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113157 | Medicaid | SC |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nephrology and Hypertension Medical Associates PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Jesup, GA
- NPI 1730663857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275436800000",
"number": "1376550582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1859 NORTH PARIS AVENUE",
"address_2": "SUITE 212",
"city": "PORT ROYAL",
"state": "SC",
"postal_code": "299352047",
"telephone_number": "843-524-2002",
"fax_number": "843-524-2002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1859 NORTH PARIS AVENUE",
"address_2": "SUITE 212",
"city": "PORT ROYAL",
"state": "SC",
"postal_code": "299352047",
"telephone_number": "843-524-2002",
"fax_number": "843-524-3522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHENOY",
"first_name": "KATAPADI",
"middle_name": "SURENDRA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2010-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "SC",
"license": "11315",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "113157",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Royal, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.