Vijay Kumar Rekhala, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD029239E Issued in PA

Practice address

1705 Warren Ave
Suite 209
Williamsport, PA 17701-2647

Phone

(570) 326-1283

NPI assigned

Jul 26, 2006

Last updated

Jan 5, 2017By 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 2

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1821011164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1774 MCCONNELL DR",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177019300",
            "telephone_number": "570-326-1283",
            "fax_number": "570-326-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 WARREN AVE",
            "address_2": "SUITE 209",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177012647",
            "telephone_number": "570-326-1283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REKHALA",
        "first_name": "VIJAY",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD029239E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009159600001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "432264",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy E Reidy, DOM, AP, L.AC
• Madeline Gabrielle Reighard, CRNP
• Christopher E Reilly, MD
• Tara Reis
• Kaytlyn Reitenbach, PHDHP
• Alyssa Remley, RN
• Residential Home Health of NC PA, LLC
• Raymond S Resnick, M.D.
• Response Link L.L.C. (Alert1/Alertone Services)
• Retina Group of Pennsylvania, P.C.

• Psychiatry Physician in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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.