Ravi Yadava, D.O.

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

104036 Issued in MO

Practice address

675 Old Ballas Rd
Suite 210
Saint Louis, MO 63141-7083

Phone

(314) 994-9355

Fax

(314) 994-0796

NPI assigned

Sep 7, 2005

Reactivated

May 1, 2006

Sex

Male

Sole proprietor

Yes

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 MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

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

• Ravi Yadava, D.O. PC

  • Physical Medicine & Rehabilitation Physician
  • Saint Louis, MO
  • NPI 1114155124
  Medicare reassignment Authorized official
• Ravi Yadava, DO PC

  • Nurse Practitioner
  • Saint Louis, MO
  • NPI 1013327998
  NPD (past)

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144214065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 OLD BALLAS RD",
            "address_2": "SUITE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417083",
            "telephone_number": "314-994-9355",
            "fax_number": "314-994-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 OLD BALLAS RD",
            "address_2": "SUITE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417083",
            "telephone_number": "314-994-9355",
            "fax_number": "314-994-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YADAVA",
        "first_name": "RAVI",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2007-07-08",
        "deactivation_date": "2006-03-25",
        "reactivation_date": "2006-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "MO",
            "license": "104036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Y.I.W. Home Healthcare
• Shira H Yablok, MS, CCC-SLP
• Devvrat Yadav, MD
• Madan Yadav, LPC
• Rajiv L Yadava, DO
• Shivi Yadava, DO
• Garrett Michael Yadro, CRNA
• Michelle Yager, PHARM.D
• Missy K Yager, DPT
• Yagoub Abubaker Yagoub Ibrahim, M.B.B.S.

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.