DR. RAVI KUDUMULA (NPI# 1225250129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225250129 |
| Entity Type | Individual |
| Full Name | DR. RAVI KUDUMULA |
| Credential | M.D. |
| Practice Address |
11115 Parkview Plaza Dr Fort Wayne IN 46845-1701 |
| Mailing Address |
1234 E Dupont Rd Suite 1 Fort Wayne IN 46825-1545 |
| Practice Telephone | 2606726400 |
| Practice Fax Number | 2606726459 |
| Mailing Telephone | 2603737854 |
| Mailing Fax Number | 2604585664 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2015-05-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 43609 | TN | Allopathic & Osteopathic Physicians |
| N | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
43609 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q001555 | 05 |
| Street Address |
11115 PARKVIEW PLAZA DR |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-1701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932106317 | Jayesh P Patel | Pediatrics | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2005-06-30 |
| 1003473307 | Angela Booth | Registered Nurse | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2019-05-22 |
| 1942696356 | Sarah E Brandenberger | Genetic Counselor, MS | 11115 Parkview Plaza Dr, Attn: Sarah King, Fort Wayne, IN 46845-1701 | 2015-04-13 |
| 1588058739 | Halie Hoang Kudumula | Nurse Practitioner | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2015-03-26 |
| 1639425291 | Lisa Marie Piwoszkin | Pediatrics | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2012-07-31 |
| 1235424482 | Christen A Merkler | Nurse Practitioner | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2011-06-16 |
| 1730400714 | Rachel Miller | Registered Nurse | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2010-06-14 |
| 1104950799 | Win Boon | Pediatrics | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2007-03-15 |
| 1700984002 | Emily J Deneve | Nurse Practitioner | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2006-09-20 |
| 1992812861 | Professional Emergency Physicians Inc | Emergency Medicine | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2006-08-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
| 1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
| 1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
| 1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
| Find all providers in zip 46845 | ||||
| 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 |
|---|---|---|---|---|
| 1538554399 | Allison Soldner | Pediatrics | 2810 Dupont Commerce Ct, Fort Wayne, IN 46825 | 2015-03-30 |
| 1689939191 | Katherine Elizabeth Welch | Pediatrics | 3308 Rosewood Dr, Fort Wayne, IN 46804-6110 | 2012-07-10 |
| 1881847721 | William C. Ashman | Pediatrics | 6750 Covington Creek Trail, Fort Wayne, IN 46804 | 2008-10-23 |
| 1114061231 | Lalitha Sayed | Pediatrics | 3030 Lake Ave Ste 10, Fort Wayne, IN 46805-5428 | 2007-02-20 |
| 1013077825 | Lindsay M Ligler | Pediatrics | 2514 E. Dupont Rd, Fort Wayne, IN 46825 | 2006-12-11 |
| 1275546913 | Christopher Philip Tallo | Pediatrics | 2510 East Dupont Road, Suite 236, Fort Wayne, IN 46825 | 2006-08-14 |
| 1982614343 | Lynda K Otto | Pediatrics | 2402 Lake Ave, Fort Wayne, IN 46805-5406 | 2006-08-09 |
| 1013936814 | Michael Philip Dick | Pediatrics | 3898 New Vision Dr, Fort Wayne, IN 46845 | 2006-07-19 |
| 1881678860 | Northeast Indiana Genetic Counseling Center Inc | Pediatrics | 11143 Parkview Plaza Dr, Ste. 311, Fort Wayne, IN 46845-1701 | 2005-12-02 |
| 1932106317 | Jayesh P Patel | Pediatrics | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2005-06-30 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
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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.