Individual provider Active NPI

Shivarajpur K Ravi, M.D.

  • Interventional Pain Medicine Physician
  • Baytown, TX
National Provider Identifier
1235193558
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
J3882 Issued in TX
Practice address
2802 Garth Rd
Suite 207
Baytown, TX 77521-3900
Phone
(281) 428-7330
Fax
(281) 428-7251
NPI assigned
Apr 13, 2006
Last updated
Jan 11, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X J3882 TX
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X J3882 TX
Interventional Pain Medicine Physician 208VP0014X J3882 TX Primary

Addresses

Primary practice location

2802 Garth Rd
Suite 207
Baytown, TX 77521-3900

Mailing address

2802 Garth Rd
Suite 207
Baytown, TX 77521-3900
Phone (281) 428-7330

Other identifiers 1

IdentifierTypeStateIssuer
115563202MedicaidTX

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
J3882TXMDInterventional Pain Medicine Physician

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1235193558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2802 GARTH RD",
            "address_2": "SUITE 207",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775213900",
            "telephone_number": "281-428-7330",
            "fax_number": "281-428-7251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 GARTH RD",
            "address_2": "SUITE 207",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775213900",
            "telephone_number": "281-428-7330",
            "fax_number": "281-428-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVI",
        "first_name": "SHIVARAJPUR",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "J3882",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "TX",
            "license": "J3882",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TX",
            "license": "J3882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115563202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baytown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.

Verify at the official NPI Registry.