NPIMap

Individual provider Active NPI

Shruthi Ponnala, MD

  • Hospitalist Physician
  • Bermuda Run, NC
National Provider Identifier
1831711191
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2024-03218 Issued in NC
Practice address
329 NC Highway 801 N
Bermuda Run, NC 27006-7905
Phone
(336) 998-2228
NPI assigned
May 9, 2020
Last updated
Apr 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 74497 MN
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 2024-03218 NC Primary

Addresses

Primary practice location

329 NC Highway 801 N
Bermuda Run, NC 27006-7905

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 998-2228

Other practice location 1

1575 Beam Ave
Maplewood, MN 55109-2545
Phone (651) 232-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230721001836 MN Practitioner - Internal Medicine 9931569977 Reassigns benefits to 2 organizations
I20250425000186 NC Practitioner - Internal MedicinePractitioner - Hospitalist 9931569977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-4380

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
89.73
Promoting interoperability
100
Improvement activities
40
Cost
80.99

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74497MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Moses Cone Physician Services, Inc. Internal Medicine Current Accepting new patients
Moses Cone Physician Services Inc Hospitalist CurrentSince Jul 1, 2025 Accepting new patients
Healtheast Medical Research Institute Internal Medicine CurrentSince Jul 28, 2023 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jul 28, 2023 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Health Services CurrentSince Jul 28, 2023 Accepting new patients
Healtheast St. John's Hospital Past Accepting new patients

Locations

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

300 E Wendover Ave
Fl 2
Greensboro, NC 27401
Phone (336) 663-5219

Interoperability endpoints

  • Direct secure messaging: shruthi.ponnala.1@18107.direct.athenahealth.com
  • Direct secure messaging: sponnala2998910@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: sponnala795051@fairview.direct-ci.com

Organizations & group practices 9

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 8

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": "1588982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1831711191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-998-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 NC HIGHWAY 801 N",
            "city": "BERMUDA RUN",
            "state": "NC",
            "postal_code": "270067905",
            "telephone_number": "336-998-2228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1575 Beam Ave",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551092545",
            "country_code": "US",
            "telephone_number": "651-232-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONNALA",
        "first_name": "SHRUTHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-09",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "74497",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2024-03218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bermuda Run, NC

Sources for this page

Verify at the official NPI Registry.