Individual provider Active NPI

Suneetha Somireddy, MD

  • Psychiatry Physician
  • Columbia, MO
National Provider Identifier
1558473124
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2007007868 Issued in MO
Practice address
1 Hospital Dr
Columbia, MO 65201-5276
Phone
(573) 882-0451
Fax
(573) 884-5396
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2007007868 MO Primary

Addresses

Primary practice location

1 Hospital Dr
Columbia, MO 65201-5276

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131

Other practice location 1

616 Burkarth Rd
Warrensburg, MO 64093-1462
Phone (888) 403-1071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20080718000168 MO Practitioner - Psychiatry 2567535990 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007007868MOMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Psychiatric Hospital Inc CurrentSince Jul 1, 2008 Accepting new patients

Locations

1800 Community
#B
Clinton, MO 64735

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

307 N Main St
Windsor, MO 65360
Phone (660) 647-2182

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1558473124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015276",
            "telephone_number": "573-882-0451",
            "fax_number": "573-884-5396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "616 Burkarth Rd",
            "address_purpose": "LOCATION",
            "city": "Warrensburg",
            "state": "MO",
            "postal_code": "640931462",
            "country_code": "US",
            "telephone_number": "888-403-1071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOMIREDDY",
        "first_name": "SUNEETHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2007007868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.