VENKAT DEVINENI, MD, INC (NPI# 1619108164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619108164 |
| Entity Type | Organization |
| Organization Name | VENKAT DEVINENI, MD, INC |
| Other Organization Name | RADIANT HEART INSTITUTE |
| Practice Address |
17259 Jasmine St Suite B Victorville CA 92395-7787 |
| Mailing Address |
Po Box 1537 Victorville CA 92393-1537 |
| Practice Telephone | 7609517778 |
| Practice Fax Number | 7609517760 |
| Mailing Telephone | 7609517778 |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2009-07-31 |
| Authorized Official Name | DR. VENKAT DEVINENI (OWNER) |
| Authorized Official Telephone | 7609517778 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
A54340 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A543400 | 05 |
| Other Name | Type Code |
|---|---|
| RADIANT HEART INSTITUTE | Doing Business As Name - Organization |
| Street Address |
17259 JASMINE ST SUITE B |
| City | VICTORVILLE |
| State | CA |
| Zip Code | 92395-7787 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851387948 | Anupama Sharma | Internal Medicine | 17259 Jasmine St, Suite B, Victorville, CA 92395 | 2005-09-23 |
| 1619456449 | Lisa Morales | Nurse Practitioner | 17259 Jasmine St, Victorville, CA 92395-7787 | 2018-08-13 |
| 1144754763 | Linda Njoku | Nurse Practitioner | 17259 Jasmine St, Suite B, Victorville, CA 92395-7787 | 2017-04-20 |
| 1740505742 | Alliance Desert Physicians | Pediatrics | 17259 Jasmine St, Suite B, Victorville, CA 92395-7787 | 2010-04-01 |
| 1922212653 | Anupama Sharma Md Inc | Clinic/Center | 17259 Jasmine St, Suite B, Victorville, CA 92395-7787 | 2007-05-10 |
| 1619995016 | Akhil Sharma | Pediatrics | 17259 Jasmine St, Suite A, Victorville, CA 92395-7787 | 2006-07-17 |
| 1629012422 | April Lynette De La Cruz | Physician Assistant | 17259 Jasmine St, Ste B, Victorville, CA 92395-7787 | 2006-06-15 |
| 1588650675 | Venkat Devineni | Internal Medicine | 17259 Jasmine St, Suite B, Victorville, CA 92395 | 2005-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837966 | Desert Ridge Transitional Care Center, Lp | Skilled Nursing Facility | 13300 11th Avenue, Victorville, CA 92395 | 2020-06-26 |
| 1376179093 | Catherine Ward | Speech-Language Pathologist | 13275 Mauka Ct, Victorville, CA 92395 | 2020-03-13 |
| 1174019228 | Laura Mercado Halterman | Family Medicine | 16519 Victor St Ste 307, Victorville, CA 92395 | 2018-07-02 |
| 1306337829 | Stephanie Ann Kruger | Behavior Technician | Sunny Days Inc 3602 Inland Empire Blvd., Ontario, CA 92395 | 2018-05-21 |
| 1861903924 | Debra L Andersen | Clinic/Center | 12830 Hesperia Road, Suite C, D, E, Victorville, CALIFORNIA 92395 | 2017-10-17 |
| 1790202141 | Joshua Powers | Physician Assistant | 12550 Hesperia Rd Ste 101, Victorville, CA 92395 | 2017-08-26 |
| 1043759491 | Kemp Individual & Family Therapy, Inc. | Marriage & Family Therapist | 14075 Hesperia Road, Suite 101, Victorville, CA 92395 | 2017-02-17 |
| 1740725969 | Abem Transportation Inc | Non-emergency Medical Transport (VAN) | 15000 7th St Ste F208, Victorville, CA 92395 | 2016-12-23 |
| 1447669379 | Tracie Girard | Nurse Practitioner | 17330 Bear Valley Road, Suite A106, Victorville, CA 92395 | 2014-08-05 |
| 1093153215 | Mitesh Patel | Surgery | 13010 Hesperia Rd Ste 400, Victorville, CA 92395 | 2013-06-10 |
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| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| City | VICTORVILLE |
| Zip Code | 92395 |
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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.