NPIMap

Individual provider Active NPI

Surinder P S Sra, M.D.

  • Internal Medicine Physician
  • Cherokee VLG, AR
National Provider Identifier
1700845740
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E0496 Issued in AR
Practice address
197 Hospital Dr
Suite B
Cherokee VLG, AR 72529-7314
Phone
(870) 257-5118
NPI assigned
Mar 20, 2006
Last updated
Jul 16, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E0496 AR Primary

Addresses

Primary practice location

197 Hospital Dr
Suite B
Cherokee VLG, AR 72529-7314

Mailing address

197 Hospital Dr
Suite B
Cherokee VLG, AR 72529-7314
Phone (870) 257-5118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050331001194 AR Practitioner - Internal Medicine 6103873245 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
White River Health System, Inc.Group PAC ID 0143134270, 190 clinicians

Practice addresses (Care Compare)

1710 Harrison St Slot
24 White River Emergency Physicians
Batesville, AR 72501-7303
Phone (870) 262-1240

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E0496ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Diagnostics Inc Internal Medicine CurrentSince Oct 14, 1999 Accepting new patients
WRMC Internal Medicine Clinic Internal Medicine CurrentSince Dec 1, 2021 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1710 Harrison St
Batesville, AR 72501
Phone (870) 262-1240

1710 Harrison St
#24
Batesville, AR 72501
Phone (870) 262-1240

197 Hospital Dr
Ste B
Cherokee Vlg, AR 72529
Phone (870) 257-5118

Interoperability endpoints

  • Direct secure messaging: surinder.sra@imd.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1700845740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 HOSPITAL DR",
            "address_2": "SUITE B",
            "city": "CHEROKEE VLG",
            "state": "AR",
            "postal_code": "725297314",
            "telephone_number": "870-257-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 HOSPITAL DR",
            "address_2": "SUITE B",
            "city": "CHEROKEE VLG",
            "state": "AR",
            "postal_code": "725297314",
            "telephone_number": "870-257-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRA",
        "first_name": "SURINDER",
        "middle_name": "P S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E0496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.