Active NPI
Dharmaja Raviendran, MD
- Psychiatry Physician
- Centennial, CO
National Provider Identifier
1215013487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 23098
- Practice address
- 8120 S Holly
#112
Centennial, CO 80122 - Phone
- (303) 777-2220
- Fax
- (303) 777-1221
- NPI assigned
- Oct 31, 2006
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 23098 | CO | Primary |
Addresses
Primary practice location
8120 S Holly
#112
Centennial, CO 80122
Mailing address
8120 S Holly
#112
Centennial, CO 80122
Phone (303) 777-2220
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
| License | State | Type | Specialty |
|---|---|---|---|
| 23098 | CO | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207785600000",
"number": "1215013487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8120 S HOLLY",
"address_2": "#112",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "80122",
"telephone_number": "303-777-2220",
"fax_number": "303-777-1221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8120 S HOLLY",
"address_2": "#112",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "80122",
"telephone_number": "303-777-2220",
"fax_number": "303-777-1221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAVIENDRAN",
"first_name": "DHARMAJA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-31",
"last_updated": "2008-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CO",
"license": "23098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centennial, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.