NPIMap

Organization Active NPI

Two Rivers Medical

  • General Practice Physician
  • Bradenton, FL
National Provider Identifier
1639062946
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
TWO RIVERS MEDICAL
Practice address
2812 Manatee Ave E
Bradenton, FL 34208-1828
Phone
(941) 226-0206
Fax
(941) 900-1043
NPI assigned
Jun 3, 2025
Last updated
Jul 22, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
TWO RIVERS URGENT CARE AND WELLNESSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Authorized official

Name
Mr. Jaya Krishna Kolla, MDNPI 1811123789
Title
Owner
Phone
(941) 226-0206

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

2812 Manatee Ave E
Bradenton, FL 34208-1828

Mailing address

2810 Manatee Ave E
2810 Manatee Ave E
Bradenton, FL 34208-1828
Phone (941) 226-0206

National Provider Directory

National Provider Directory
Tax ID family
Two Rivers Urgent Care and Wellness2 organizations share this tax ID, including this one
Part of
Two Rivers Urgent Care and Wellness

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2812 Manatee Ave E
Bradenton, FL 34208
Phone (941) 226-0206

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

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": "1748908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753142400000",
    "number": "1639062946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 MANATEE AVE E",
            "address_2": "2810 MANATEE AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081828",
            "telephone_number": "941-226-0206",
            "fax_number": "941-900-1043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 MANATEE AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081828",
            "telephone_number": "941-226-0206",
            "fax_number": "941-900-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWO RIVERS MEDICAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TWO RIVERS URGENT CARE AND WELLNESS",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-11",
        "status": "A",
        "authorized_official_last_name": "KOLLA",
        "authorized_official_first_name": "JAYA",
        "authorized_official_middle_name": "KRISHNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-226-0206",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.