Indra Sriram, M.D.

Primary specialty

Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X

License

MMD.36130 MD Issued in SC

Practice address

168 Carolina Ridge Dr
Columbia, SC 29229-7396

Phone

(260) 602-4645

NPI assigned

Jun 22, 2005

Reactivated

Mar 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Indrambikai Sriram Other name

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1790781938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 CAROLINA RIDGE DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297396",
            "telephone_number": "260-602-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 CAROLINA RIDGE DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297396",
            "telephone_number": "260-602-4645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIRAM",
        "first_name": "INDRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2014-07-10",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "IN",
            "license": "01040404",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IN",
            "license": "01040404",
            "primary": false
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "SC",
            "license": "MMD.36130 MD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100439910",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "INDRAMBIKAI",
            "last_name": "SRIRAM",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Michael Gordon Sribnick, M.D.
• Richard L. Sribnick, M.D., P.A.
• Wayne B Sribnick, MD
• Mohan Sridaran, DO
• Shilpa Srinivasan, MD
• Neeraj Sriram, MD
• SS Dental LLC
• St Andrews Operator LLC
• St Chris Home Care LLC
• Mary Ann St John, MA, LPC

• Adolescent Medicine (Internal Medicine) Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Adolescent Medicine (Internal Medicine) Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.