Latha M. Ravichandran

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M5460 Issued in TX

Practice address

1602 Rock Prairie Rd Ste 2400
College Station, TX 77845-0001

Phone

(979) 693-2586

Fax

(979) 693-7327

NPI assigned

Dec 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Family Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Joseph Regional Health CenterGroup PAC ID 5294727921, 141 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St Joseph Health Regional Hospital Hospital, Bryan, TX, CCN 450011

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: latha.ravichandran@sjrhc.eclinicaldirectplus.com
• Direct secure messaging: lravichandran458099@direct.stlukeshealth.org

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.

• St. Joseph Regional Health Center

  • Family Medicine Physician
  • Bryan, TX
  • NPI 1669557179
  Medicare reassignment Care Compare group NPD
• Regional Employee Assistance Program Inc

  • Family Medicine Physician
  • Corsicana, TX
  • NPI 1649232984
  Medicare reassignment NPD
• Apogee Medical Group Texas PA

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1558318071

  TX

  Medicare reassignment NPD
• Regional Employee Assistance Program Inc

  • Internal Medicine Physician
  • College Station, TX
  • NPI 1053373951

  Family Medicine

  NPD
• Regional Employee Assistance Program Inc

  • Cardiovascular Disease Physician
  • Abilene, TX
  • NPI 1073575585

  Family Medicine

  NPD
• St Joseph Regional Health Center

  • Rural Health Clinic/Center
  • Franklin, TX
  • NPI 1780768911
  NPD
• Brazos Valley Community Action Agency, Inc.

  • Obstetrics Physician
  • College Station, TX
  • NPI 1811171580
  NPD (past)
• College Station Hospital LP

  • Rehabilitation Hospital Unit
  • College Station, TX
  • NPI 1548286297
  NPD (past)
• Privia Medical Group Gulf Coast PLLC

  • Interventional Pain Medicine Physician
  • San Antonio, TX
  • NPI 1457167033
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Regional Health Center

  • General Acute Care Hospital
  • Bryan, TX
  • NPI 1942294939
  Care Compare affiliation
• St. Joseph Regional Health Center

  • General Acute Care Hospital
  • College Station, TX
  • NPI 1053963009
  Care Compare affiliation

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1902966443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 ROCK PRAIRIE RD STE 2400",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778450001",
            "telephone_number": "979-693-2586",
            "fax_number": "979-693-7327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 ROCK PRAIRIE RD STE 2400",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778450001",
            "telephone_number": "979-693-2586",
            "fax_number": "979-693-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVICHANDRAN",
        "first_name": "LATHA",
        "middle_name": "M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M5460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154467803",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI CLINIC",
            "identifier": "1649265646",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187842301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI AGENCY",
            "identifier": "1821185299",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185649401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "309188603",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "741715140",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000951607",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000951608",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154467801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Ramirez, LVN
• Daniel Grier Ransom, M.D.
• Cody Rapp, CRNA
• Craig Lynn Raschke, D.C.
• Juan Raudales, MD
• Aaron Ray, CRNA
• Patrick J Ray, PH.D.
• William Lowell Rayburn, M.D.
• RC Pharmacy LLC
• RDD Dev LLC

• Family Medicine Physician in College Station, TX
• Providers in College Station, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.