Individual provider Active NPI

Priyanka Ravi, MD,FRCPC

  • Anatomic Pathology Physician
  • Saint Louis, MO
National Provider Identifier
1972384196
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
2023012592 Issued in MO
Practice address
1402 S Grand Blvd
Saint Louis, MO 63104-1004
Phone
(314) 417-9510
NPI assigned
Oct 12, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0101X 2023012592 MO Primary

Addresses

Primary practice location

1402 S Grand Blvd
Saint Louis, MO 63104-1004

Mailing address

1716 Kenmont Rd
Saint Louis, MO 63124-1022
Phone (314) 417-9510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2023012592MOMDAnatomic Pathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1972384196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 KENMONT RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241022",
            "telephone_number": "314-417-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041004",
            "telephone_number": "314-417-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVI",
        "first_name": "PRIYANKA",
        "credential": "MD,FRCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology",
            "state": "MO",
            "license": "2023012592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.