Organization Active NPI

Ravi Medi

  • Psychiatry Physician
  • Odessa, TX
National Provider Identifier
1235286535
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
RAVI MEDI
Practice address
2626 John Ben Shepperd Pkwy
C-129
Odessa, TX 79761-1958
Phone
(432) 333-1333
Fax
(432) 333-1335
NPI assigned
Jan 5, 2007
Last updated
Jun 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Mrs. Madu Medi
Title
Office Manager
Phone
(432) 333-1333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2626 John Ben Shepperd Pkwy
C-129
Odessa, TX 79761-1958

Mailing address

2626 John Ben Shepperd Pkwy
C-129
Odessa, TX 79761-1958
Phone (432) 333-1333

Other identifiers 1

IdentifierTypeStateIssuer
1578296-01MedicaidTX

Other names 1

  • RAVI MEDI Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050323000431 TX Part B Supplier - Clinic/Group Practice 4789630781 Receives reassigned benefits from 1 practitioner
Practice locations: Odessa, TX; Midland, TX

National Provider Directory

National Provider Directory

Locations

211 E Texas Ave
Midland, TX 79701
Phone (432) 682-0577

2626 John Ben Shepperd Pkwy
Ste C129
Odessa, TX 79761
Phone (432) 333-1333

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1235286535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 JOHN BEN SHEPPERD PKWY",
            "address_2": "C-129",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797611958",
            "telephone_number": "432-333-1333",
            "fax_number": "432-333-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 JOHN BEN SHEPPERD PKWY",
            "address_2": "C-129",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797611958",
            "telephone_number": "432-333-1333",
            "fax_number": "432-333-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVI MEDI",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "MEDI",
        "authorized_official_first_name": "MADU",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "432-333-1333",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578296-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RAVI MEDI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.