RATHNA SREE MALLELA (NPI# 1194043554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194043554 |
| Entity Type | Individual |
| Full Name | RATHNA SREE MALLELA |
| Credential | M.D., M.P.H. |
| Practice Address |
2600 Humes Rd Ste 100 Janesville WI 53545-0491 |
| Practice Telephone | (608) 741-2117 |
| Practice Fax Number | 6087585761 |
| Mailing Telephone | (608) 741-2117 |
| Mailing Fax Number | 6087585761 |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
64316-20 | WI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | DEANHEALTH PLAN | 1194043554 | 01 |
| WI | 1194043554 | 05 | |
| WI | WI MEDICARE | K400258432-000054176 | 01 |
| WI | BCBSWI | 1194043554 | 01 |
| WI | WI MEDICARE | K400258434-00084908 | 01 |
| WI | MERCYCARE INSURANCE | MALLERAT | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 20 E Court St, Janesville, WI 535453919 | 6087558923 | 6087585761 |
| Street Address |
2600 HUMES RD STE 100 |
| City | JANESVILLE |
| State | WI |
| Zip Code | 53545-0491 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851546667 | Amanda L Ballard | Counselor | 2600 Humes Rd Ste 100, Janesville, WI 53545 | 2008-11-20 |
| 1376178350 | Monica L. Hinkle | Social Worker | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2020-03-10 |
| 1467082313 | Jacquelyn M. O'flahrity | Social Worker | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2020-01-20 |
| 1972163004 | Danielle R. Ebben | Counselor | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2019-06-20 |
| 1518521186 | Debra K. Westby | Social Worker | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2019-04-29 |
| 1881165991 | Sarah A. Wellnitz | Social Worker | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2018-12-16 |
| 1568986578 | Deborah A. Dubanowich | Counselor | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2017-08-01 |
| 1699143909 | Jessica L Jach | Social Worker | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2015-09-03 |
| 1336529932 | Phillip L. Stall | Psychiatry & Neurology | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2015-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730743816 | Wisteria Lyn Gunnink | Social Worker | 3530 N County Highway F, Janesville, WI 53545 | 2019-04-24 |
| 1730601295 | Selma Mohammedi | Dentist | 1260 Milton Ave Ste 140-150, Janesville, WI 53545 | 2017-07-16 |
| 1205357472 | Andrea Jayne Thompson | Physical Therapist | 3418 N Parker Dr., Janesville, WI 53545 | 2017-06-28 |
| 1639549983 | Sylvia Andrus | Physical Therapy Assistant | 3400 N Country Highway F, Janesville, WI 53545 | 2015-09-30 |
| 1518372564 | Kimberly Ann Bishop | Registered Nurse | 32 E. Racine Street, Suite 150, Janesville, WI 53545 | 2014-06-29 |
| 1679998314 | Quirt Family Dentistry | Dentist | 2201 Humes Road Suite 150, Janesville, WI 53545 | 2014-03-04 |
| 1104163740 | Sarah J Fredricks | Licensed Practical Nurse | 1406 Holiday Drive, Janesville, WI 53545 | 2013-01-15 |
| 1659629335 | Parvin Mesbah | Pharmacist | 2017 Old Humes Road, T-0809, Janesville, WI 53545 | 2012-08-28 |
| 1962797118 | Tiffany Schmidt | Pharmacist | 2017 Humes Road, T-0809, Janesv Ille, WI 53545 | 2011-06-16 |
| 1174817795 | Megan Steiner | Dentist | 1504 Creston Park Drive, Janesville, WI 53545 | 2011-05-31 |
| Find all providers in zip 53545 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104384387 | Center for Emotional Wellness LLC. | Psychiatry & Neurology | W156n8327 Pilgrim Rd Ste 301, Menomonee Fls, WI 53051-3776 | 2019-03-06 |
| 1295000255 | Ilsa Bick | Psychiatry & Neurology | 1099 Highland Dr, Kohler, WI 53044-1306 | 2012-03-09 |
| 1215268453 | Richard Carl Zimmerman | Psychiatry & Neurology | 1282 E. Green Lake Dr., West Bend, WI 53090-9069 | 2010-01-28 |
| 1184800880 | William M Buzogany | Psychiatry & Neurology | W350 S1401 Waterville Road, Lad Lake Inc, Dousman, WI 53118 | 2008-01-14 |
| 1033300199 | Monika Drummond Roots | Psychiatry & Neurology | 3140 Oxford Rd, Madison, WI 53705-2224 | 2007-08-05 |
| 1598974321 | Marta Cristina Muller | Psychiatry & Neurology | 1941 N Battle Creek Rd, Oconomowoc, WI 53066-9468 | 2007-05-21 |
| 1164517082 | Moitreyee Bandyopadhyay Reddy | Psychiatry & Neurology | 9000 W.wisconsin Avenue, Milwaukee, WI 53201-1997 | 2006-10-04 |
| 1639182868 | Thomas E. Wright | Psychiatry & Neurology | 120 East Main Street, Cambridge, WI 53523-0548 | 2006-08-15 |
| 1447262183 | Neil P Fullan | Psychiatry & Neurology | 2475 University Ave Ste A, Green Bay, WI 54302-5099 | 2006-08-12 |
| 1396761276 | Robert Perzacki | Psychiatry & Neurology | 1820 Appleton Rd, Menasha, WI 54952-1110 | 2006-07-14 |
| Find all providers with the same taxonomy | ||||
| City | JANESVILLE |
| Zip Code | 53545 |
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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.