Individual provider Active NPI

Jayanthi Ravikumar, M.D.

  • Physical Medicine & Rehabilitation Physician
  • La Palma, CA
National Provider Identifier
1679528053
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A33094 Issued in CA
Practice address
5451 La Palma Ave
Suite 47
La Palma, CA 90623-1732
Phone
(714) 226-0818
Fax
(714) 226-0202
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A33094 CA Primary

Addresses

Primary practice location

5451 La Palma Ave
Suite 47
La Palma, CA 90623-1732

Mailing address

3356 W. Ball Road
Suite 216
Anaheim, CA 92804
Phone (714) 226-0818

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Rehabilitation Medical Group, Inc. Physical Medicine & Rehabilitation Past Accepting new patients
Geller Medical Corporation Physical Medicine & Rehabilitation Past Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
Cerritos Dialysis Center LLC PastSince Aug 28, 2002 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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1679528053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3356 W. BALL ROAD",
            "address_2": "SUITE 216",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92804",
            "telephone_number": "714-226-0818",
            "fax_number": "714-226-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5451 LA PALMA AVE",
            "address_2": "SUITE 47",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231732",
            "telephone_number": "714-226-0818",
            "fax_number": "714-226-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVIKUMAR",
        "first_name": "JAYANTHI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A33094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Palma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; 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.