Individual provider Active NPI

Devika Hanumara Sood, MD

  • Family Medicine Physician
  • Falling Waters, WV
National Provider Identifier
1528239696
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
WV23371 Issued in WV
Practice address
1179 T J Jackson Dr
Falling Waters, WV 25419-4698
Phone
(304) 820-1031
Fax
(304) 820-1033
NPI assigned
Mar 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X WV23371 WV Primary

Addresses

Primary practice location

1179 T J Jackson Dr
Falling Waters, WV 25419-4698

Mailing address

1179 T J Jackson Dr
Falling Waters, WV 25419-4698
Phone (304) 820-1031

Other identifiers 1

IdentifierTypeStateIssuer
3810013779MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20090302000357 WV Practitioner - Family Practice 8224194147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cardinal Healthcare PLLCGroup PAC ID 2264661313, 2 clinicians

Practice addresses (Care Compare)

1179 T J Jackson Dr
A
Falling Waters, WV 25419-4698
Phone (304) 820-1031

Hospital & facility affiliations

  • Berkeley Medical Center Hospital, Martinsburg, WV, CCN 510008
  • Jefferson Medical Center Hospital, Ranson, WV, CCN 511319

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
WV23371WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Healthcare Physicians, Inc. Family Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dsood1014@direct.wvuhsdirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1528239696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 T J JACKSON DR",
            "city": "FALLING WATERS",
            "state": "WV",
            "postal_code": "254194698",
            "telephone_number": "304-820-1031",
            "fax_number": "304-820-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 T J JACKSON DR",
            "city": "FALLING WATERS",
            "state": "WV",
            "postal_code": "254194698",
            "telephone_number": "304-820-1031",
            "fax_number": "304-820-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOOD",
        "first_name": "DEVIKA",
        "middle_name": "HANUMARA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-17",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "WV23371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810013779",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Falling Waters, WV

Sources for this page

Verify at the official NPI Registry.