Individual provider Active NPI

Rakhee Reddy, MD

  • General Practice Physician
  • Marianna, FL
National Provider Identifier
1063153906
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1544 Issued in FL
Practice address
4719 Highway 90
Marianna, FL 32446-7839
Phone
(850) 526-3314
Fax
(850) 526-5022
NPI assigned
Apr 5, 2022
Last updated
Aug 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Physician 208D00000X ACN1544 FL Primary

Addresses

Primary practice location

4719 Highway 90
Marianna, FL 32446-7839

Mailing address

4719 Highway 90
Marianna, FL 32446-7839
Phone (850) 526-3314

Other practice location 1

1108 Ross Clark Cir Ste 210
Dothan, AL 36301-3022
Phone (334) 712-3329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230829000722 FL Practitioner - General Practice 6608239397 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Caremed Clinic LLCGroup PAC ID 0446589469, 3 clinicians

Practice addresses (Care Compare)

4719 Hwy 90
Marianna, FL 32446-7839
Phone (850) 526-3314

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN1544FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caremed Clinic LLC CurrentSince Aug 17, 2023 Accepting new patients
Caremed Urgent Care LLC CurrentSince Aug 17, 2023 Accepting new patients

Locations

951 Prim Ave
Ste 20
Graceville, FL 32440
Phone (850) 360-4000

4719 Highway 90
Marianna, FL 32446
Phone (850) 526-3314

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20680/brand/1/csg/1/fhir/r4
  • Direct secure messaging: rakhee.reddy.1@20680.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1063153906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4719 HIGHWAY 90",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324467839",
            "telephone_number": "850-526-3314",
            "fax_number": "850-526-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4719 HIGHWAY 90",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324467839",
            "telephone_number": "850-526-3314",
            "fax_number": "850-526-5022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1108 Ross Clark Cir Ste 210",
            "address_purpose": "LOCATION",
            "city": "Dothan",
            "state": "AL",
            "postal_code": "363013022",
            "country_code": "US",
            "telephone_number": "334-712-3329",
            "fax_number": "334-305-0219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDY",
        "first_name": "RAKHEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marianna, FL

Sources for this page

Verify at the official NPI Registry.