Individual provider Active NPI

Chandana Ravikumar, D.O.

  • Neonatal-Perinatal Medicine Physician
  • Dallas, TX
National Provider Identifier
1366977530
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
S6717 Issued in TX
Practice address
7777 Forest Lane
Dallas, TX 75230-1501
Phone
(972) 566-4730
NPI assigned
Apr 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neonatal-Perinatal Medicine Physician 2080N0001X S6717 TX Primary

Addresses

Primary practice location

7777 Forest Lane
Dallas, TX 75230-1501

Mailing address

3001 E George Bush Hwy. Suite 225
Richardson, TX 75082
Phone (214) 343-6663

Other practice location 1

1441 N. Beckley Ave.
Dalla, TX 75203-1501
Phone (214) 947-3099

Other practice location 2

6200 W Parker Rd
Plano, TX 75093-1501
Phone (972) 981-7611

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)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
S6717TXMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Medical Group of Texas Billing, Inc. Neonatal-Perinatal Medicine PastSince Jul 2, 2023 Accepting new patients
Columbia Hospital at Medical City Dallas Subsidiary LP Past Accepting new patients
Methodist Hospitals of Dallas Past Accepting new patients
Ut Physicians PastSince Apr 1, 2020 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1366977530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 E GEORGE BUSH HWY. SUITE 225",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "75082",
            "telephone_number": "214-343-6663",
            "fax_number": "214-343-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LANE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752301501",
            "telephone_number": "972-566-4730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1441 N. Beckley Ave.",
            "address_purpose": "LOCATION",
            "city": "Dalla",
            "state": "TX",
            "postal_code": "752031501",
            "country_code": "US",
            "telephone_number": "214-947-3099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6200 W Parker Rd",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750931501",
            "country_code": "US",
            "telephone_number": "972-981-7611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVIKUMAR",
        "first_name": "CHANDANA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "S6717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.