Active NPI
Sravanthi Pallapothu, PT
- Physical Therapist
- Jacksonville, IL
National Provider Identifier
1154867539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070020669
- Practice address
- 1600 W Walnut St
Jacksonville, IL 62650-1136 - Phone
- (217) 245-9541
- Fax
- (217) 479-8781
- NPI assigned
- Jan 10, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070020669 | IL | Primary |
Addresses
Primary practice location
1600 W Walnut St
Jacksonville, IL 62650-1136
Mailing address
1600 W Walnut St
Jacksonville, IL 62650-1136
Phone (217) 245-9541
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Passavant Memorial Area Hospital Association | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Jacksonville, IL
- NPI 1760994040
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484006400000",
"number": "1154867539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 W WALNUT ST",
"city": "JACKSONVILLE",
"state": "IL",
"postal_code": "626501136",
"telephone_number": "217-245-9541",
"fax_number": "217-479-8781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 W WALNUT ST",
"city": "JACKSONVILLE",
"state": "IL",
"postal_code": "626501136",
"telephone_number": "217-245-9541",
"fax_number": "217-479-8781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALLAPOTHU",
"first_name": "SRAVANTHI",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-10",
"last_updated": "2017-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070020669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.