NPIMap

Organization Active NPI

Two Rivers Urgent Care and Wellness

  • Urgent Care Clinic/Center
  • Bradenton, FL
National Provider Identifier
1639765399
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
TWO RIVERS URGENT CARE AND WELLNESS
Doing business as
Two Rivers Urgent Care and Wellness
Practice address
2810 Manatee Ave East
Bradenton, FL 34208
Phone
(941) 226-0206
Fax
(941) 900-1043
NPI assigned
Dec 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Authorized official

Name
Mr. Jaya K Kolla, MDNPI 1811123789
Title
MD/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
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

2810 Manatee Ave East
Bradenton, FL 34208

Mailing address

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

Other names 1

  • Two Rivers Urgent Care and Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210126000195 FL Part B Supplier - Clinic/Group Practice 7113331679 Receives reassigned benefits from 3 practitioners
Practice locations: Bradenton, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2216662Two Rivers Urgent Care and Wellness LLC2810 Manatee Ave E, Bradenton, FL 34208Certificate of waiverMar 14, 2027

National Provider Directory

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

Other organizations with this tax ID 1

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

Locations

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23341/brand/1/csg/1/fhir/r4

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1639765399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 MANATEE AVE EAST",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34208",
            "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": "2810 MANATEE AVE EAST",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34208",
            "telephone_number": "941-226-0206",
            "fax_number": "941-900-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWO RIVERS URGENT CARE AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-16",
        "last_updated": "2023-12-06",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "KOLLA",
        "authorized_official_first_name": "JAYA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "941-226-0206",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Two Rivers Urgent Care and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.