Lalitha V Sarvadevabhatla, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10678-024 Issued in WI

Practice address

1420 N Marshall St
#204
Milwaukee, WI 53202-2761

Phone

(414) 421-0088

NPI assigned

May 13, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Lalitha Venkata Kota Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1245407725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 N MARSHALL ST",
            "address_2": "#204",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532022761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 N MARSHALL ST",
            "address_2": "#204",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532022761",
            "telephone_number": "414-421-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARVADEVABHATLA",
        "first_name": "LALITHA",
        "middle_name": "V",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-13",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012117",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10678-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LALITHA",
            "last_name": "KOTA",
            "middle_name": "VENKATA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physical Therapist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.