Individual provider Active NPI

Chandroth Velandy Purushothaman, MD

  • Specialist
  • Morehead City, NC
National Provider Identifier
1760534275
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
26352 Issued in NC
Practice address
212 Penny LN
Morehead City, NC 28557-4305
Phone
(252) 247-5426
Fax
(252) 247-0287
NPI assigned
Jan 17, 2007
Last updated
Apr 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 26352 NC Primary

Addresses

Primary practice location

212 Penny LN
Morehead City, NC 28557-4305

Mailing address

212 Penny LN
Morehead City, NC 28557-4305
Phone (252) 247-5426

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120613000205 NC Practitioner - Cardiovascular Disease (Cardiology) 1456515923 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carteret Medical Group LLCGroup PAC ID 5698947794, 65 clinicians

Practice addresses (Care Compare)

1165 Cedar Point Blvd
Cedar Point, NC 28584-1030

221 A Professional Cir
Morehead City, NC 28557-4303
Phone (252) 499-8300

302 Medical Park CT
Morehead City, NC 28557-4346
Phone (252) 247-2013

306 Medical Park CT
Morehead City, NC 28557-4346
Phone (252) 247-2101

3500 Arendell St
Morehead City, NC 28557-2901
Phone (252) 247-2013

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26352NCMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Carteret Medical Group LLC CurrentSince Sep 25, 2024 Accepting new patients
Carteret County General Hospital Corporation CurrentSince May 13, 1995 Accepting new patients

Locations

1165 Cedar Point Blvd
Ste H
Cedar Point, NC 28584
Phone (252) 499-6850

221B Professional Cir
Morehead City, NC 28557
Phone (252) 222-0195

302 Medical Park Ct
Morehead City, NC 28557
Phone (252) 247-2013

3500 Arendell St
Morehead City, NC 28557
Phone (252) 499-6000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15484/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1760534275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 PENNY LN",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285574305",
            "telephone_number": "252-247-5426",
            "fax_number": "252-247-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 PENNY LN",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285574305",
            "telephone_number": "252-247-5426",
            "fax_number": "252-247-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURUSHOTHAMAN",
        "first_name": "CHANDROTH",
        "middle_name": "VELANDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "26352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead City, NC

Sources for this page

Verify at the official NPI Registry.