Prabha Sudheendran, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

013382 Issued in TN

Practice address

4299 Elvis Presley Blvd
Memphis, TN 38116

Phone

(901) 398-7518

Fax

(901) 398-3128

NPI assigned

Oct 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Prabhavathy Sudheendran Former name

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: prabha.sudheendran.1@20250.direct.athenahealth.com
• Direct secure messaging: prabha.sudheendran.p1@direct.mphshc.nextgenshare.com

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.

• Memphis Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Memphis, TN
  • NPI 1144236902
  Medicare reassignment NPD
• Memphis Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Memphis, TN
  • NPI 1659745354
  NPD

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1487742755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 E EH CRUMP BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381265310",
            "telephone_number": "901-261-2000",
            "fax_number": "901-946-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4299 ELVIS PRESLEY BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38116",
            "telephone_number": "901-398-7518",
            "fax_number": "901-398-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDHEENDRAN",
        "first_name": "PRABHA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "013382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3189854",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRABHAVATHY",
            "last_name": "SUDHEENDRAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nina Katherine Sublette, PHD, FNP
• Alhassan Sameh Suboh, FNP
• Poorna Subramaniam
• Katie Joy Suda, PHARMD, M.S.
• Joseph Michael Sudderth
• Sudie S Cushman
• Sugar Pros PC
• Jecarta Bernadette Suggs, BLS
• Debra Mehuron Suiter, PH.D.
• Ali Y Suliman, MD, MSC

• Pediatrics Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.