Jagannadha Rao Rayavarapu, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME80138 Issued in FL

Practice address

1720 S Gadsden St
Tallahassee, FL 32301-5506

Phone

(850) 576-4073

Fax

(850) 577-0675

NPI assigned

Sep 28, 2006

Last updated

Jan 16, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Santa Rosa Hma Physician Management LLC

  • Family Medicine Physician
  • Pace, FL
  • NPI 1043880347
  NPD (past)
• Santa Rosa Hma Physician Management, LLC

  • Family Medicine Physician
  • Milton, FL
  • NPI 1447365366
  NPD (past)
• TBHC Medical Services PC

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1508959743
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389830400000",
    "number": "1780775122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 S GADSDEN ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323015506",
            "telephone_number": "850-576-4073",
            "fax_number": "850-577-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 S GADSDEN ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323015506",
            "telephone_number": "850-576-4073",
            "fax_number": "850-577-0675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYAVARAPU",
        "first_name": "JAGANNADHA",
        "middle_name": "RAO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2014-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME80138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263972601",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263972600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263972602",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263972604",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263972605",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263972603",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263972606",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264779600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chantelle Katina Ray, MSW
• Jayshawn Ray
• Nichole Jeneen Ray
• Ronald D Ray, MD
• Sarah Frances Ray
• Traci R Raybon
• Raychel Powers, Psy. D. LLC (Powers of Mind Psychological Servcies)
• Amanda Raymer
• Rebecca Raymond
• Ana E Raynolds, M.S. CF-SLP

• Pediatrics Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; 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.