Mehta Medicine Group LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

MEHTA MEDICINE GROUP LLC

Practice address

2475 Hillcrest Center Cir
Winston Salem, NC 27103-3048

Phone

(704) 787-4537

NPI assigned

Jun 4, 2021

Organization subpart

No

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

Authorized official

Name

Sudeep Mehta, MDNPI 1912353400

Title

Owner

Phone

(704) 787-4537

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sudeep Kirtikumar Mehta, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Winston Salem, NC
  • NPI 1912353400
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622764800000",
    "number": "1992372320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 HEATHER GLEN RD",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280816410",
            "telephone_number": "704-787-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 HILLCREST CENTER CIR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033048",
            "telephone_number": "704-787-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEHTA MEDICINE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "SUDEEP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-787-4537",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mediq Urgent Care PC
• Macy Chassereau Medlock
• Lauren Hinchee Meek, DDS
• Htay Meh
• Diana Cristina Mehedint, MD
• Sujata Mehta-Looney, PA
• Dhaval Mehta
• Sudeep Kirtikumar Mehta, M.D.
• Kathryn Elizabeth Meiners, PA-C
• Jessica Marie Meister Berger, MD, JD

• Physical Medicine & Rehabilitation Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Physical Medicine & Rehabilitation Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; 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.

Verify at the official NPI Registry.