Individual provider Active NPI

Sumna E Kuruvilla, MD

  • Adult Medicine Physician
  • Monroe, LA
National Provider Identifier
1922117837
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
11335R Issued in LA
Practice address
250 Desiard Plaza Dr
VA Clinic
Monroe, LA 71203-4955
Phone
(318) 345-5599
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 11335R LA Primary

Addresses

Primary practice location

250 Desiard Plaza Dr
VA Clinic
Monroe, LA 71203-4955

Mailing address

2703 Brierfield Dr
Monroe, LA 71201-3048
Phone (318) 388-3151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130715000588 LA Order and Referring Only - Family PracticePractitioner - Family Practice 3577703594

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11335RLAMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Transit, Inc. Past Accepting new patients
Northeast Rural Health Center Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922117837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 BRIERFIELD DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013048",
            "telephone_number": "318-388-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 DESIARD PLAZA DR",
            "address_2": "VA CLINIC",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712034955",
            "telephone_number": "318-345-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURUVILLA",
        "first_name": "SUMNA",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "LA",
            "license": "11335R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.