Medicherla Shyam Sunder Kumar, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

0101033814 Issued in VA

Practice address

401 Sewell Road
Sparta, TN 38583

Phone

(931) 743-6291

NPI assigned

Jul 25, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1932622644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LONG POINT DR",
            "city": "ROCK ISLAND",
            "state": "TN",
            "postal_code": "385813424",
            "telephone_number": "931-743-6291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SEWELL ROAD",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "38583",
            "telephone_number": "931-743-6291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "MEDICHERLA",
        "middle_name": "SHYAM SUNDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101033814",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101033814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scotty Lee Kirby, DC
• Misty Christine Knowles, BSN, RN
• Robert B Knowles, M.D.
• Stephanie Sue Knowles, FNP-BC
• Kalyani Medicherla Kumar, M.D.
• Abbi Kuykendall, OTD/L
• Kristen Lee
• Legacy Behavioral Health
• Jason Lee Lewis, MA, MBC, LMFT, MPA
• Life Force, LLC

• Cardiovascular Disease Physician in Sparta, TN
• Providers in Sparta, TN by specialty
• Cardiovascular Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.