Individual provider Active NPI

Thanesan Gurumurthi, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Edgewood, KY
National Provider Identifier
1639466139
Registry record updated Jul 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
R2476 Issued in KY
Practice address
413 S Loop Rd
Edgewood, KY 41017-5446
Phone
(859) 301-3800
NPI assigned
Jul 5, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X R2476 KY Primary

Addresses

Primary practice location

413 S Loop Rd
Edgewood, KY 41017-5446

Mailing address

681 Napa Valley LN
Apt 11
Crestview Hills, KY 41017-5110
Phone (859) 814-4496

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R2476KYMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309824000000",
    "number": "1639466139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 NAPA VALLEY LN",
            "address_2": "APT 11",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410175110",
            "telephone_number": "859-814-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 S LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175446",
            "telephone_number": "859-301-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURUMURTHI",
        "first_name": "THANESAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-05",
        "last_updated": "2011-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KY",
            "license": "R2476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; 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.