Latha Ravi, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

036-072768 Issued in IL

Practice address

180 South Third Street
Suite 102
Belleville, IL 62220

Phone

(618) 235-2511

Fax

(618) 235-2548

NPI assigned

Jul 29, 2006

Sex

Female

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1801801717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 SOUTH THIRD STREET",
            "address_2": "SUITE 102",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62220",
            "telephone_number": "618-235-2511",
            "fax_number": "618-235-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 SOUTH THIRD STREET",
            "address_2": "SUITE 102",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62220",
            "telephone_number": "618-235-2511",
            "fax_number": "618-235-2548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVI",
        "first_name": "LATHA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036-072768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "0008200539",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "250002252",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH PLAN",
            "identifier": "33725",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Michelle Ramirez, QMHP
• Laurel Ranck
• Lauren Randazzo
• Samantha Rardin, RN
• Ravensong Counseling Services LLC
• David P Rawdon, MD
• Melissa Ray, MS
• Denise G Read, ST
• Sarah Read, LCSW
• Rebecca Hartfield D.M.D., P.C.

• Physical Medicine & Rehabilitation Physician in Belleville, IL
• Providers in Belleville, IL by specialty
• Physical Medicine & Rehabilitation Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.