Jaya Venkataraman, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

38751 Issued in TN

Practice address

3180 Professional Plaza
Suite 111
Germantown, TN 38138

Phone

(901) 854-5455

Fax

(901) 861-7736

NPI assigned

Jul 28, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jvenkataraman4023158@oc.providencedirect.org

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.

• Collierville Pediatrics, LLC

  • Pediatrics Physician
  • Collierville, TN
  • NPI 1326229345
  Medicare reassignment NPD Authorized official
• Midsouth Independent Group, PLLC

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1861009326
  Medicare reassignment NPD
• Pediatric Emergency Specialists, PC

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Memphis, TN
  • NPI 1760482434
  NPD (past)
• Pediatric Sedation Specialists, PC

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Memphis, TN
  • NPI 1881686814
  NPD (past)
• Providence Health & Services - Oregon

  • Internal Medicine Physician
  • Sherwood, OR
  • NPI 1184729329

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1487654752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 PROFESSIONAL PLAZA",
            "address_2": "SUITE 111",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "38138",
            "telephone_number": "901-854-5455",
            "fax_number": "901-861-7736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 PROFESSIONAL PLAZA",
            "address_2": "SUITE 111",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "38138",
            "telephone_number": "901-854-5455",
            "fax_number": "901-861-7736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2028 W Poplar Ave Ste 112",
            "address_purpose": "LOCATION",
            "city": "Collierville",
            "state": "TN",
            "postal_code": "380170618",
            "country_code": "US",
            "telephone_number": "901-854-5455",
            "fax_number": "901-861-7736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENKATARAMAN",
        "first_name": "JAYA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "TN",
            "license": "38751",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "38751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Vasireddy, PA-C
• Catherine Alexander Vaughan, M.D.
• Paige Vazeii, PTA
• Pamela A Venegas, M.D.
• Brooke Veneklase, M.C.D.,CCC-SLP
• Rebecca Vergho, SLP
• Marianna Rutherford Vescovo
• Ryan Edward Vick, DDS
• Gregory Vidal, M.D
• Elizabeth Marie Vigus, TLPC-MHSP

• Pediatrics Physician in Germantown, TN
• Providers in Germantown, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.