NPIMap

Organization Active NPI

Supra Vascular Associates PLC

  • Specialist
  • Allen Park, MI
National Provider Identifier
1811401045
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SUPRA VASCULAR ASSOCIATES PLC
Practice address
16507 Southfield Rd
Allen Park, MI 48101-2503
Phone
(313) 389-0648
Fax
(313) 389-3510
NPI assigned
Nov 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Authorized official

Name
Dr. Sudheer Ummadi, MDNPI 1437118106
Title
Manager
Phone
(313) 389-0648

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

16507 Southfield Rd
Allen Park, MI 48101-2503

Mailing address

16507 Southfield Rd
Allen Park, MI 48101-2503
Phone (313) 389-0648

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548806400000",
    "number": "1811401045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16507 SOUTHFIELD RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012503",
            "telephone_number": "313-389-0648",
            "fax_number": "313-389-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16507 SOUTHFIELD RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012503",
            "telephone_number": "313-389-0648",
            "fax_number": "313-389-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPRA VASCULAR ASSOCIATES PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-27",
        "last_updated": "2019-01-30",
        "status": "A",
        "authorized_official_last_name": "UMMADI",
        "authorized_official_first_name": "SUDHEER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "313-389-0648",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.