Sudesh Banaji, MD, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

E2308 Issued in AR

Legal business name

SUDESH BANAJI, MD, PLLC

Doing business as

Internal Medicine of Forrest City

Practice address

332 E Cook St
Forrest City, AR 72335-2830

Phone

(870) 630-2233

Fax

(870) 630-2224

NPI assigned

Oct 25, 2006

Last updated

Mar 24, 2011By 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. Sudesh Banaji, MDNPI 1003815192

Title

Owner

Phone

(870) 630-2233

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Internal Medicine of Forrest City Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Sudesh Banaji MD PLLC

  dba Earle Family Medical Clinic

  • Rural Health Clinic/Center
  • Earle, AR
  • NPI 1639319411

  4486719879

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Earle Family Medical Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sudesh Banaji MD PLLC

  dba Earle Family Medical Clinic

  • Rural Health Clinic/Center
  • Earle, AR
  • NPI 1639319411
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Deanna Michaelis, FNP

  • Family Nurse Practitioner
  • Forrest City, AR
  • NPI 1265949895
  Medicare reassignment NPD
• Purnima Sarkar, MD

  • Internal Medicine Physician
  • Earle, AR
  • NPI 1205899572
  Medicare reassignment
• Sudesh Banaji, M.D

  • Internal Medicine Physician
  • Forrest City, AR
  • NPI 1003815192
  Authorized official Same address or phone
• Dut Majok Dut, APN

  • Family Nurse Practitioner
  • Jonesboro, AR
  • NPI 1881329928
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300924800000",
    "number": "1659455830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 E COOK ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352830",
            "telephone_number": "870-630-2233",
            "fax_number": "870-630-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 E COOK ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352830",
            "telephone_number": "870-630-2233",
            "fax_number": "870-630-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUDESH BANAJI, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2011-03-24",
        "status": "A",
        "authorized_official_last_name": "BANAJI",
        "authorized_official_first_name": "SUDESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-630-2233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E2308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138381001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BCBS",
            "identifier": "5L309",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BCBS",
            "identifier": "5F219",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Internal Medicine of Forrest City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• State of Arkansas (Arkansas Department of Health Hospice 9E)
• Kaitlin Claire Stephens
• Vanessa Stephens, RN
• Felicia Samantha Stewart
• Angela Stingley, RN
• Supermarket Investors Inc (Harvest Foods Pharmacy)
• Bethany R Sutton, M.S., CCC-SLP
• Kristy Swindle, OTD/OTR/L
• Whitney Terry
• The Littles, Inc (The Littles Pediatric Clinic)

• Internal Medicine Physician in Forrest City, AR
• Providers in Forrest City, AR by specialty
• Internal Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.