NPIMap

Individual provider Active NPI

Kothai Divya Guruswamy Sangameswaran, MD

  • Nephrology Physician
  • Fayetteville, NC
National Provider Identifier
1871933051
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
32956 Issued in OK
Practice address
557 Sandhurst Dr
Fayetteville, NC 28304-4433
Phone
(910) 484-8114
Fax
(910) 223-0511
NPI assigned
Jul 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 32956 OK Primary
Nephrology Physician 207RN0300X 2020-00969 NC

Addresses

Primary practice location

557 Sandhurst Dr
Fayetteville, NC 28304-4433

Mailing address

557 Sandhurst Dr
Fayetteville, NC 28304-4433
Phone (910) 484-8114

Other names 1

  • Kothai Divya Guruswamy Sangameswaran Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200622001168 NC Practitioner - Nephrology 0840524112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolina Kidney Care PAGroup PAC ID 4587576020, 24 clinicians

Practice addresses (Care Compare)

557 Sandhurst Dr
Fayetteville, NC 28304-4433
Phone (910) 484-8114

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.91 of 100Reported as group
Quality
60.8
Promoting interoperability
100
Improvement activities
40
Cost
86.4

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2002-00969NCMDSpecialist
2020-00969NCMDNephrology Physician
32956OKMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Kidney Care, PA Nephrology CurrentSince Jul 1, 2020 Accepting new patients
Bio-Medical Applications of Fayetteville, Inc. Past Accepting new patients

Locations

219 Martin Luther King Jr Dr
Bladenboro, NC 28320

1740 Southeast Blvd
Clinton, NC 28328
Phone (910) 592-1600

101 Dialysis Dr
Elizabethtown, NC 28337
Phone (910) 862-7022

300 E McKay St
Ste D
Elizabethtown, NC 28337
Phone (910) 484-4100

704 S Walnut St
Fairmont, NC 28340
Phone (910) 628-6898

526 Ramsey St
Fayetteville, NC 28301
Phone (704) 989-1800

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

130 Longview Dr
Fayetteville, NC 28311
Phone (910) 482-3491

6959 Nexus Ct
Fayetteville, NC 28304
Phone (910) 867-2602

2560 Legion Rd
Fayetteville, NC 28306
Phone (910) 323-5288

557 Sandhurst Dr
Fayetteville, NC 28304

300 W 27th St
Lumberton, NC 28358
Phone (910) 671-5000

1250 Linkhaw Rd
Lumberton, NC 28358
Phone (910) 348-8760

720 Wesley Pines Rd
Lumberton, NC 28358
Phone (910) 738-2421

810 Wesley Pines Rd
Lumberton, NC 28358
Phone (910) 618-1055

1327 Harry West Ln
Pembroke, NC 28372
Phone (910) 522-7126

285 Paraclete Dr
Raeford, NC 28376
Phone (910) 878-0052

300 Medical Pavilion Dr
Ste 320
Raeford, NC 28376
Phone (910) 266-9900

403 S Main St
Raeford, NC 28376
Phone (910) 875-6561

11016 Red Springs Rd
Red Springs, NC 28377
Phone (910) 843-3205

1000 E 4th Ave
Red Springs, NC 28377
Phone (910) 843-9311

100 E Pleasant St
Roseboro, NC 28382
Phone (910) 525-0405

Interoperability endpoints

  • Direct secure messaging: kpragatheeshwar24425@direct.acumenmd.com
  • Direct secure messaging: kpragatheeshwar846271@direct.unc.nchie.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1871933051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 SANDHURST DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044433",
            "telephone_number": "910-484-8114",
            "fax_number": "910-223-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 SANDHURST DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044433",
            "telephone_number": "910-484-8114",
            "fax_number": "910-223-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANGAMESWARAN",
        "first_name": "KOTHAI DIVYA",
        "middle_name": "GURUSWAMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-02",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OK",
            "license": "32956",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NC",
            "license": "2020-00969",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KOTHAI DIVYA",
            "last_name": "SANGAMESWARAN",
            "middle_name": "GURUSWAMY",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.