Individual provider Active NPI

Ramchandra Nallu, M.D

  • Pediatrics Physician
  • Lakeland, FL
National Provider Identifier
1891751814
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME141106 Issued in FL
Practice address
1920 Lakeland Hills Blvd
Lakeland, FL 33805-2902
Phone
(863) 683-4661
NPI assigned
Apr 26, 2006
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35-077589N OH
Pediatrics Physician 208000000X ME141106 FL Primary

Addresses

Primary practice location

1920 Lakeland Hills Blvd
Lakeland, FL 33805-2902

Mailing address

3111 Lake Ellen Dr
Tampa, FL 33618-3617
Phone (419) 302-0888

Other practice location 1

1220 E Elm St
Ste-220
Lima, OH 45804-2850
Phone (419) 229-5437

Other identifiers 2

IdentifierTypeStateIssuer
116614500MedicaidFL
2224140MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250320002910 FL Practitioner - Pediatric Medicine 6002884392 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-077589NOHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Collier Health Services, Inc CurrentSince Feb 25, 2025 Accepting new patients
Collier Health Services Inc CurrentSince Feb 25, 2025 Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Lima Memorial Professional Corporation Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Pediatrics Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Pediatrics Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients

Locations

1454 Madison Ave W
Immokalee, FL 34142
Phone (239) 658-3064

125 Boston Ave
Immokalee, FL 34142
Phone (239) 657-5800

1441 Heritage Blvd
Immokalee, FL 34142
Phone (239) 624-8050

5450 Ymca Rd
#102
Naples, FL 34109

1845 Veterans Park Dr
Naples, FL 34109
Phone (239) 571-9015

6350 Davis Blvd
Unit 1001
Naples, FL 34104

1090 6th Ave N
Naples, FL 34102
Phone (239) 213-9200

9160 Galleria Ct
Naples, FL 34109
Phone (239) 514-8787

12655 Collier Blvd
Naples, FL 34116
Phone (239) 571-9015

Interoperability endpoints

  • Direct secure messaging: ramchandra.nallu.1@10865.direct.athenahealth.com

Organizations & group practices 36

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.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1891751814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 LAKE ELLEN DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336183617",
            "telephone_number": "419-302-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338052902",
            "telephone_number": "863-683-4661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 E Elm St",
            "address_2": "STE-220",
            "address_purpose": "LOCATION",
            "city": "Lima",
            "state": "OH",
            "postal_code": "458042850",
            "country_code": "US",
            "telephone_number": "419-229-5437",
            "fax_number": "419-229-9992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NALLU",
        "first_name": "RAMCHANDRA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-077589N",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME141106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116614500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2224140",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.