SUNEETHA KODURU (NPI# 1891885968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891885968 |
| Entity Type | Individual |
| Full Name | SUNEETHA KODURU |
| Credential | MD |
| Practice Address |
1625 David Raines Rd Shreveport LA 71107-5899 |
| Practice Telephone | 3184252252 |
| Practice Fax Number | 3188416044 |
| Mailing Telephone | 3184252252 |
| Mailing Fax Number | 3188416044 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2011-09-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 200884 | LA | Allopathic & Osteopathic Physicians |
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
200884 | LA | Allopathic & Osteopathic Physicians |
| Street Address |
1625 DAVID RAINES RD |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71107-5899 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558386847 | David Joseph Bellew | Dentist | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2006-07-13 |
| 1558918722 | Bisi Joseph Ekundayo | Dentist | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2019-08-22 |
| 1144705930 | David Raines Community Health Center Inc | Clinic/Center | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2018-09-27 |
| 1871019406 | Shamika Nicole Calhoun | Nurse Practitioner | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2017-08-15 |
| 1114472875 | Dana Sumbler | Nurse Practitioner | 1625 David Raines Rd, Shreveport, LA 71107-2712 | 2016-08-23 |
| 1245531987 | Alexandra K Drake | Nurse Practitioner | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2010-11-11 |
| 1508178559 | Benjamin Joseph Bumgardner | Dentist | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2010-07-07 |
| 1245560879 | Magdalyn A Thomas | Dentist | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2010-01-04 |
| 1821228909 | Pratibha Anne | Family Medicine | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2009-07-22 |
| 1487880407 | Sadaf Javaid | Psychiatry & Neurology | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2009-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306490875 | Kimber Leigh Lumley | Registered Nurse | 1440 Hawn Ave., Shreveport, LA 71107 | 2019-08-01 |
| 1871063461 | Nicole Capito | Case Manager/Care Coordinator | 200 North Thomas Drive Ste 1, Shreveport, LA 71107 | 2018-11-27 |
| 1891260899 | Danielle Leigh Dreher | Dental Assistant | 3610 Gorman Rd, Shreveport, LA 71107 | 2018-10-05 |
| 1255817540 | Shirley Marie Washington | Technician | 3227 Old Mooringsport Rd., Shreveport Rd, LA 71107 | 2018-07-19 |
| 1366928467 | Katrina L Bailey | Case Manager/Care Coordinator | 1111 Hawn Ave Apt A, Shreveport, LA 71107 | 2018-07-12 |
| 1063907970 | James Mcneely IIi | Public Health or Welfare | 5922 Alaska Ln, Shreveport, LA 71107 | 2018-06-25 |
| 1528560067 | Jacarie Guice | Case Manager/Care Coordinator | 4601 N. Market Ste 2, Shreveport, LA 71107 | 2018-03-01 |
| 1467971069 | Tracy Renard Harris | Counselor | 1149 Englemeade Dr, Shreveport, LA 71107 | 2017-09-14 |
| 1427588045 | Mark Rogers | Behavior Technician | 1500 N. Market Unit C Suite 105, Shreveport, LA 71107 | 2017-06-15 |
| 1356871164 | Hope4youth | Voluntary or Charitable | 2850 King Oaks Loop, Shreveport, LA 71107 | 2017-06-14 |
| Find all providers in zip 71107 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841245842 | William R. Wise | Emergency Medicine | 1121 Gatewood Circle, Shreveport, LA 71106 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639662539 | Doctor By Video,llc | Emergency Medicine | 1700 Central Blvd, Harvey, LA 70058-3288 | 2018-06-14 |
| 1780028175 | Wayne Thomas Robichaux | Emergency Medicine | 12 Muirfield Dr, La Place, LA 70068-1632 | 2013-04-29 |
| 1639474257 | C&m Medical Services-st Elizabeth LLC | Emergency Medicine | 1125 West Louisiana Highway 30, Gonzales, LA 70737 | 2011-01-12 |
| 1972705333 | Isaac Freeborn | Emergency Medicine | 1507 E Whatley Rd, Oakdale, LA 71463-2318 | 2007-06-05 |
| 1609097898 | Wesley Blake Vanderlan | Emergency Medicine | 400 S Chenier Dr, Madisonville, LA 70447-9389 | 2007-05-02 |
| 1801945936 | Louis Christopher Benjamin IIi | Emergency Medicine | 18961 Santa Maria Dr, Baton Rouge, LA 70809-6765 | 2007-01-09 |
| 1134235989 | Victor E Tuckler | Emergency Medicine | 639 Gelpi Ave, Jefferson, LA 70121-1527 | 2006-08-22 |
| 1710903059 | C & M Medical Services, Inc. | Emergency Medicine | 2450 Severn Ave Ste 205, Metairie, LA 70001 | 2006-07-13 |
| 1720014392 | Huey August Seyfarth Jr. | Emergency Medicine | 1424 Sherwood Forest Blvd, Baton Rouge, LA 70815-5332 | 2006-06-24 |
| 1073554010 | Gina Luisa Greco-angelopoulos | Emergency Medicine | 2640 Country Club Rd, Suite 400, Lake Charles, LA 70605-5912 | 2006-06-09 |
| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71107 |
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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.