Active NPI
Sai Sanjeevani Medical Group LLC
- Internal Medicine Physician
- Clarksdale, MS
National Provider Identifier
1871361121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- SAI SANJEEVANI MEDICAL GROUP LLC
- Practice address
- 785 Ohio Ave
Clarksdale, MS 38614-6217 - Phone
- (662) 351-0702
- NPI assigned
- Dec 15, 2023
- Last updated
- Feb 7, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Gowdhami Mohan, MD
- Title
- Medical Director
- Phone
- (662) 351-0702
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
785 Ohio Ave
Clarksdale, MS 38614-6217
Mailing address
785 Ohio Ave
Clarksdale, MS 38614-6217
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Sleep Medicine (Internal Medicine) Physician
- Clarksdale, MS
- NPI 1114921806
-
- Pediatric Infectious Diseases Physician
- Clarksdale, MS
- NPI 1811006901
-
- Psychologist
- Clarksdale, MS
- NPI 1457120545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702598400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1707264000000",
"number": "1871361121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "785 OHIO AVE",
"city": "CLARKSDALE",
"state": "MS",
"postal_code": "386146217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "785 OHIO AVE",
"city": "CLARKSDALE",
"state": "MS",
"postal_code": "386146217",
"telephone_number": "662-351-0702"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAI SANJEEVANI MEDICAL GROUP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-12-15",
"last_updated": "2024-02-07",
"certification_date": "2024-02-07",
"status": "A",
"authorized_official_last_name": "MOHAN",
"authorized_official_first_name": "GOWDHAMI",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "662-351-0702",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksdale, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.