Active NPI
Kumudini Vemula, M.D.
- Pediatrics Physician
- Detroit, MI
National Provider Identifier
1689881138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- AS3062508-195
- Practice address
- 22201 Moross Rd
Suite 7O Pbii
Detroit, MI 48236-2169 - Phone
- (313) 343-3800
- NPI assigned
- May 16, 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | AS3062508-195 | MI | Primary |
Addresses
Primary practice location
22201 Moross Rd
Suite 7O Pbii
Detroit, MI 48236-2169
Mailing address
21401 Sloan Dr
#109
Harper Woods, MI 48225-2431
Phone (313) 887-9947
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
| License | State | Type | Specialty |
|---|---|---|---|
| AS3062508-195 | MI | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689881138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21401 SLOAN DR",
"address_2": "#109",
"city": "HARPER WOODS",
"state": "MI",
"postal_code": "482252431",
"telephone_number": "313-887-9947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22201 MOROSS RD",
"address_2": "SUITE 7O PBII",
"city": "DETROIT",
"state": "MI",
"postal_code": "482362169",
"telephone_number": "313-343-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEMULA",
"first_name": "KUMUDINI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "AS3062508-195",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.