Lakshmi Kalyani Gudavalli, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

070020357 Issued in IL

Practice address

275 E Carl Sandburg Drive
Marigold Rehabilitation
Galesburg, IL 61401

Phone

(309) 344-1151

NPI assigned

Sep 18, 2014

Last updated

Sep 18, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cortlyn Therapy PCGroup PAC ID 8729495684, 141 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cortlyn Therapy, PC

  dba Symbria Outpatient Services

  • Physical Therapist
  • Cincinnati, OH
  • NPI 1235725730

  IA, Orthopedic

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1063814309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2834 VILLA CT",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527227554",
            "telephone_number": "563-639-2486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 E CARL SANDBURG DRIVE",
            "address_2": "MARIGOLD REHABILITATION",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "61401",
            "telephone_number": "309-344-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDAVALLI",
        "first_name": "LAKSHMI",
        "middle_name": "KALYANI",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IL",
            "license": "070020357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Jordan Green, FNP
• Brandi N Grimes, CADC
• David Lawrence Gross, RPH
• Kimberly Anne Grotts, MS, CCC-SLP
• Grounded Perspectives, LLC (Grounded Perspectives)
• Madan L Gupta, MD
• Melissa Hajostek, APN
• Christa Ann Hamilton, LPN
• Trisha Hanson, SLP
• Brenda Harrell, MHP

• Orthopedic Physical Therapist in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Orthopedic Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.