Radiant Path Psychiatry PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

RADIANT PATH PSYCHIATRY PLLC

Practice address

330 King St Ste 5
Wenatchee, WA 98801-2857

Phone

(509) 797-7493

Fax

(833) 913-2345

NPI assigned

Mar 30, 2020

Organization subpart

No

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

Authorized official

Name

Raul Alexander Padilla, PMHNP-BCNPI 1932481124

Title

Ceo

Phone

(509) 797-7493

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, NJ, NH3 enrollments

Enrollment records 3

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23440/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raul A Padilla Jr., PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Wenatchee, WA
  • NPI 1932481124

  NH, NJ

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1225666951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 KING ST STE 5",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 KING ST STE 5",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012857",
            "telephone_number": "509-797-7493",
            "fax_number": "833-913-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "422 Morris Ave Ste 7",
            "address_purpose": "LOCATION",
            "city": "Long Branch",
            "state": "NJ",
            "postal_code": "077406574",
            "country_code": "US",
            "telephone_number": "509-797-7493",
            "fax_number": "833-913-2345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "66 Hanover St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031012230",
            "country_code": "US",
            "telephone_number": "509-797-7493",
            "fax_number": "833-913-2345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RADIANT PATH PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-30",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "PADILLA",
        "authorized_official_first_name": "RAUL",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-797-7493",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Wenatchee, WA
• Providers in Wenatchee, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.