NISHANTH SUKUMARAN (NPI# 1538328844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538328844 |
| Entity Type | Individual |
| Full Name | NISHANTH SUKUMARAN |
| Credential | MD |
| Practice Address |
210 Medical Park Blvd Suite 200 Petersburg VA 23805-9338 |
| Mailing Address |
7202 Glen Forest Dr Suite 200 Richmond VA 23226-3781 |
| Practice Telephone | 8044311100 |
| Practice Fax Number | 8048621094 |
| Mailing Telephone | 8046732024 |
| Mailing Fax Number | 8046731796 |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2020-10-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | MD434764 | PA | Allopathic & Osteopathic Physicians |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
0101254006 | VA | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | MD434764 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
210 MEDICAL PARK BLVD SUITE 200 |
| City | PETERSBURG |
| State | VA |
| Zip Code | 23805-9338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801217468 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 210 Medical Park Blvd, Suite 200, Petersburg, VA 23805-0002 | 2013-12-30 |
| 1346683182 | Brenna B Bohatec | Nurse Practitioner | 210 Medical Park Blvd, Suite 200, Petersburg, VA 23805-9338 | 2013-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134690647 | Miles Viant | Occupational Therapist | 287 E Blvd, Petersburg, VA 23805 | 2018-12-10 |
| 1245756964 | Dexter Shabazz Lett | Registered Nurse | 10543 S. Crater Rd, S. Prince George, VA 23805 | 2017-08-15 |
| 1891145876 | Taylor Enhanced Living | Counselor | 105 Holly Hill Dive, Suite A, Petersburg, VA 23805 | 2016-06-21 |
| 1700255205 | Ina Thompson | Counselor | 272 Medical Park Boulevard, Petersburg, VA 23805 | 2015-09-15 |
| 1932582541 | Valeria Edda Madrid Malo Bohorquez | Internal Medicine | 50 Medical Park Blvd Ste C, Petersburg, VA 23805 | 2015-06-30 |
| 1548642788 | Justin Andrew Phillingane | Podiatrist | 3335 S Crater Rd Ste 500, Petersburg, VA 23805 | 2015-06-24 |
| 1225417082 | Paladin Dermatology LLC | Nurse Practitioner | 44 A& B Medical Park Blvd, Petersburg, VA 23805 | 2015-05-27 |
| 1245652544 | Family Services Inc. | Health Maintenance Organization | 1045 Gustavo Lane, Petersburg, VA 23805 | 2014-01-06 |
| 1619268075 | Charlene Belangia | Massage Therapist | 3323 S. Crater Rd, Suite B, Petersburg, VA 23805 | 2011-04-20 |
| 1760709638 | Caresouth Hha Holdings of Virginia, LLC | Home Health | 34 Medical Park Boulevard, Suite G-h, Petersburg, VA 23805 | 2010-04-30 |
| Find all providers in zip 23805 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225230030 | Nathan E Langer | Internal Medicine | 210 Medical Park Blvd Ste 200, Petersburg, VA 23805-0002 | 2007-06-04 |
| 1316020399 | S.b.kondragunta LLC | Internal Medicine | 34-g Medical Park Blvd., Suite - G, Petersburg, VA 23805-9283 | 2006-10-23 |
| 1871567214 | Butchaiah Kondragunta | Internal Medicine | 34 Medical Park Blvd Ste G, Suite # G, Petersburg, VA 23805-9283 | 2006-02-14 |
| 1265406607 | Sujatha Yellinedi | Internal Medicine | 200 Medical Park Blvd, Suite 200, Petersburg, VA 23805-9274 | 2006-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093339764 | Loudoun Medical Group . P.c | Internal Medicine | 19500 Sandridge Way Ste 400, Leesburg, VA 20176-3691 | 2020-05-29 |
| 1316566839 | Stephen Smith Kennedy | Internal Medicine | 1108 Doe Mountain Rd, Goodview, VA 24095-2496 | 2020-04-14 |
| 1740640804 | Virginia Hematology Oncology Physicians Inc | Internal Medicine | 2556 Fox Hound Ct, Herndon, VA 20171-2996 | 2016-03-02 |
| 1326423260 | John J Welch | Internal Medicine | 2040 Antananarivo Pl, Dulles, VA 20189-2039 | 2015-07-21 |
| 1144637786 | Toshihisa Satta | Internal Medicine | 1250 E Marshall St # 980509, Richmond, VA 23298-5051 | 2014-07-15 |
| 1366860496 | Krista Isaac | Internal Medicine | 1215 Lee St - Box Number 800716, Charlottesville, VA 22908-0001 | 2014-04-05 |
| 1760800858 | Sonia Esparza Hepburn | Internal Medicine | 500 Sentara Cir Ste 203, Williamsburg, VA 23188-5727 | 2014-04-04 |
| 1326485202 | Kristopher Joel Hansen | Internal Medicine | 2600 Research Center Dr Ste A, Blacksburg, VA 24060 | 2013-05-31 |
| 1528326329 | Rahul Singh | Internal Medicine | 8101 Hinson Farm Rd Ste 211, Alexandria, VA 22306 | 2012-04-30 |
| 1821363219 | Oliver Alabaster | Internal Medicine | 4318 Adrienne Dr, Alexandria, VA 22309-2803 | 2012-03-19 |
| Find all providers with the same taxonomy | ||||
| City | PETERSBURG |
| Zip Code | 23805 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.