Individual provider Active NPI

Nagella Ravindra, M.D.

  • Specialist
  • St Petersburg, FL
National Provider Identifier
1083609226
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0036317 Issued in FL
Practice address
4801 49TH St N
St Petersburg, FL 33709-3859
Phone
(727) 526-3468
Fax
(727) 526-3468
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0036317 FL Primary

Addresses

Primary practice location

4801 49TH St N
St Petersburg, FL 33709-3859

Mailing address

4801 49TH St N
St Petersburg, FL 33709-3859
Phone (727) 526-3468

Other identifiers 1

IdentifierTypeStateIssuer
065105200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0036317FLMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1083609226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 49TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337093859",
            "telephone_number": "727-526-3468",
            "fax_number": "727-526-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 49TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337093859",
            "telephone_number": "727-526-3468",
            "fax_number": "727-526-3468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVINDRA",
        "first_name": "NAGELLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "0036317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065105200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.