2920 Medical Managment Group, LLC

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

Legal business name

2920 MEDICAL MANAGMENT GROUP, LLC

Practice address

6225 FM 2920
Ste 150
Spring, TX 77379

Phone

(281) 257-0404

Fax

(281) 605-4563

NPI assigned

Apr 21, 2009

Last updated

Oct 9, 2014By 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

Sushma Veera Gorrela, M.D.

Title

M.D.

Phone

(281) 257-0404

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412812800000",
    "number": "1679717763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 FM 2920",
            "address_2": "STE 100",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "77379",
            "telephone_number": "281-257-0404",
            "fax_number": "281-605-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6225 FM 2920",
            "address_2": "STE 150",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "77379",
            "telephone_number": "281-257-0404",
            "fax_number": "281-605-4563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2920 MEDICAL MANAGMENT GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-21",
        "last_updated": "2014-10-09",
        "status": "A",
        "authorized_official_last_name": "GORRELA",
        "authorized_official_first_name": "SUSHMA",
        "authorized_official_middle_name": "VEERA",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "281-257-0404",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; 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.