Southwestern Nephrology Inc

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MD035880L Issued in PA

Legal business name

SOUTHWESTERN NEPHROLOGY INC

Practice address

764 Locust Ave
Washington, PA 15301-2756

Phone

(724) 228-1303

Fax

(724) 228-1513

NPI assigned

Jun 30, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Subramonian Jaykumar, MD

Title

Owner

Phone

(724) 228-1303

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609804210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 LOCUST AVE",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153012756",
            "telephone_number": "724-228-1303",
            "fax_number": "724-228-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 LOCUST AVE",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153012756",
            "telephone_number": "724-228-1303",
            "fax_number": "724-228-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN NEPHROLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JAYKUMAR",
        "authorized_official_first_name": "SUBRAMONIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-228-1303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD035880L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0181888",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009503000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Washington, PA
• Providers in Washington, PA by specialty
• Nephrology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.