Active NPI
Surender V Kumar, M.D.
- Gynecology Physician
- Douglasville, GA
National Provider Identifier
1912077603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 014251
- Practice address
- 3327 Highway 5
Douglasville, GA 30135-2307 - Phone
- (770) 577-7030
- Fax
- (770) 577-6844
- NPI assigned
- Nov 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 014251 | GA | Primary |
Addresses
Primary practice location
3327 Highway 5
Douglasville, GA 30135-2307
Mailing address
3327 Highway 5
Douglasville, GA 30135-2307
Phone (770) 577-7030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00065029A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912077603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3327 HIGHWAY 5",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301352307",
"telephone_number": "770-577-7030",
"fax_number": "770-577-6844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3327 HIGHWAY 5",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301352307",
"telephone_number": "770-577-7030",
"fax_number": "770-577-6844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUMAR",
"first_name": "SURENDER",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "GA",
"license": "014251",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00065029A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.