DR. VENKEDESH RAJU (NPI# 1053512814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053512814 |
| Entity Type | Individual |
| Full Name | DR. VENKEDESH RAJU |
| Credential | M.D |
| Practice Address |
1001 Pennsylvania Ave Ottumwa IA 52501-6427 |
| Mailing Address |
828 Ne Glen Oak Ave 204 Stonecrest Apartments Peoria IL 61603-3285 |
| Practice Telephone | 6416827511 |
| Mailing Telephone | 3096483184 |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2020-02-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | MD-42748 | IA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 125050775 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE GROUP PTAN | 809840 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 530 Ne Glen Oak Ave, Peoria, IL 616370001 | 3096483184 |
| Street Address |
1001 PENNSYLVANIA AVE |
| City | OTTUMWA |
| State | IA |
| Zip Code | 52501-6427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659904399 | Natasha Ann Myers | Nurse Practitioner | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2020-02-21 |
| 1538709985 | Randall Craig Dieleman | Emergency Medicine | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2020-01-14 |
| 1922657337 | Yousef Ismael | Radiology | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2019-09-09 |
| 1477017663 | Emergency Services of Iowa LLC | Physician Assistant | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2019-01-22 |
| 1942793153 | Catherine Marie Hamburg | Nurse Practitioner | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2018-06-12 |
| 1467944298 | Kaylynn Charlotte Bland | Physical Therapist | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2018-06-06 |
| 1659877066 | Jennifer Lynne Cook | Anesthesiology | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2018-04-04 |
| 1447752464 | Peggy Sue Swank | Nurse Practitioner | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2018-03-06 |
| 1073038220 | Jamie Lee Hyde | Nurse Practitioner | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2017-08-09 |
| 1649794066 | Kathryn Barnes | Occupational Therapist | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2017-07-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205327210 | Speer Family Chiropractic, LLC | Chiropractor | 635 Pennsylvania Ave, Ottumwa, IA 52501 | 2018-05-24 |
| 1982194874 | Jasmine Benson | Nurse Practitioner | 1013 Pennsylvania Avenue, Suite A/b, Ottumwa, IA 52501 | 2018-05-16 |
| 1265957567 | Katie Marie Walz | Registered Nurse | 725 W. Second St., Ottumwa, IA 52501 | 2017-08-08 |
| 1033648431 | Cassadie Roberts | Occupational Therapy Assistant | 3 Pennsylvania Place, Ottumwa, IA 52501 | 2017-06-08 |
| 1588900880 | Ottumwa Er LLC | Emergency Medicine | 1001 Pennsylvania Avenue, Ottumwa, IA 52501 | 2012-12-14 |
| 1710258009 | Alcohol & Drug Dependency Services | Clinic/Center | 226 West Main St., Ottumwa, IA 52501 | 2012-01-19 |
| 1477832921 | Melissa Rohrssen | Physical Therapy Assistant | 13 Bear Creek Estates Drive, Ottumwa, IA 52501 | 2011-08-15 |
| 1578855201 | Brandy S.n. Jeansimon | Obstetrics & Gynecology | 1001 E. Pennsylvania Avenue, Ottumwa, IA 52501 | 2011-05-13 |
| 1801120399 | Frank Sam Harper | Counselor | 310 W. Main St., Ottumwa, IA 52501 | 2009-09-30 |
| 1902078439 | Sandro Younadam | Internal Medicine | 1013 Pennsylvania Avenue Suite A, Ottumwa Regional Health Center, Ottumwa, IA 52501 | 2008-03-25 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235105735 | Lona Welbourn Brager | Pediatrics | 921 Pennsylvania Ave, Ottumwa, IA 52501 | 2006-02-24 |
| 1770576373 | Nancy Collins O'brien | Pediatrics | Ottumwa Pediatrics, 931 Pennsylvania Ave, Ottumwa, IA 52501 | 2005-08-30 |
| 1851384465 | Eric Lynn Dodson | Pediatrics | 1207 N Jefferson St, Suite 1, Ottumwa, IA 52501-2021 | 2005-08-30 |
| 1235138801 | John David Wilson | Pediatrics | 931 Pennsylvania Ave, Ottumwa Pediatrics, Ottumwa, IA 52501 | 2005-07-18 |
| 1730465881 | Pediatric Associates of Ottumwa, P.C. | Pediatrics | 921 Pennsylvania Ave, Ottumwa, IA 52501 | 2011-11-02 |
| 1619115888 | All Ages Pediatrics PC | Pediatrics | 1207 N Jefferson St, Suite 1, Ottumwa, IA 52501-2021 | 2009-01-27 |
| 1992816227 | Najeeb Khalil Ahmed Ansari | Pediatrics | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2006-08-31 |
| 1215974126 | William Peyton Miller | Pediatrics | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2006-05-31 |
| 1790751824 | Debra Kay Miller | Pediatrics | 921 Pennsylvania Ave, Ottumwa, IA 52501 | 2006-02-28 |
| 1710953211 | Hazel Marian Ashraf | Pediatrics | 921 Pennsylvania Ave, Ottumwa, IA 52501 | 2006-02-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.