Active NPI
Sara Venkatasubramanian, M.D.
- Family Medicine Physician
- Raleigh, NC
National Provider Identifier
1619170016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2009-01082
- Practice address
- 2406 Blue Ridge Rd
# 190
Raleigh, NC 27607-6678 - Phone
- (919) 789-4322
- NPI assigned
- Jun 6, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2009-01082 | NC | Primary |
Addresses
Primary practice location
2406 Blue Ridge Rd
# 190
Raleigh, NC 27607-6678
Mailing address
PO Box 63362
#190
Charlotte, NC 28263-3362
Phone (919) 620-4918
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009-01082 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Specialty Physicians, LLC | Family Medicine | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458777600000",
"number": "1619170016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 63362",
"address_2": "#190",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282633362",
"telephone_number": "919-620-4918",
"fax_number": "919-620-4921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2406 BLUE RIDGE RD",
"address_2": "# 190",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276076678",
"telephone_number": "919-789-4322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENKATASUBRAMANIAN",
"first_name": "SARA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-06",
"last_updated": "2016-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "2009-01082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.