MS. SRIVIDHYA SRIDHARAN (NPI# 1720465909) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720465909 |
| Entity Type | Individual |
| Full Name | MS. SRIVIDHYA SRIDHARAN |
| Credential | MD |
| Practice Address |
1322 Locust Ave Fairmont WV 26554-1436 |
| Mailing Address |
Po Box 1112 Fairmont WV 26555-1112 |
| Practice Telephone | 3043660700 |
| Practice Fax Number | 3043678766 |
| Mailing Telephone | 3043660700 |
| Mailing Fax Number | 3043678766 |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2019-02-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 28397 | WV | Allopathic & Osteopathic Physicians |
| Street Address |
1322 LOCUST AVE |
| City | FAIRMONT |
| State | WV |
| Zip Code | 26554-1436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104887405 | Rubina K Dasilva | Physician Assistant | 1322 Locust Ave, Fairmont, WV 26554 | 2006-03-28 |
| 1639790389 | Melissa Kay Spring | Nurse Practitioner | 1322 Locust Ave, Fairmont, WV 26554-1436 | 2020-05-05 |
| 1710459557 | Miranda Jean Riggs | Nurse Practitioner | 1322 Locust Ave, Fairmont, WV 26554-1436 | 2018-12-18 |
| 1336618990 | Mark Elliott Morris | Pharmacist | 1322 Locust Ave, Fairmont, WV 26554-1436 | 2018-11-13 |
| 1598217218 | Andrea King | Nurse Practitioner | 1322 Locust Ave, Fairmont, WV 26554-1436 | 2016-10-28 |
| 1821549833 | Ravi Chandra Devabhakthuni | Physician Assistant | 1322 Locust Ave, Fairmont, WV 26554-1436 | 2016-10-14 |
| 1225489438 | Jessica Lynn Taylor | Nurse Practitioner | 1322 Locust Ave, Fairmont, WV 26554-1436 | 2016-06-29 |
| 1518328707 | Gary Michael White | Social Worker | 1322 Locust Ave, Fairmont, WV 26554-1436 | 2016-03-15 |
| 1629465786 | Michelle Wakeley | Social Worker | 1322 Locust Ave, Fairmont, WV 26554-1436 | 2015-04-16 |
| 1720487168 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1322 Locust Ave, Fairmont, WV 26554-1436 | 2014-08-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497680 | Vanquisha Clay | Technician | 118 Conaway St, Fairmont, WV 26554 | 2020-11-06 |
| 1851903363 | Denise S Greer | Technician | 1029 Prickett Road, Fairmont, WV 26554 | 2020-08-18 |
| 1730790775 | Darla Lee Mcrobie | Technician | 105 C'anna Square, Fairmont, WV 26554 | 2020-08-13 |
| 1376025718 | Jason Batten | Counselor | 621 Maryland Ave, Fairmont, WV 26554 | 2018-09-02 |
| 1437669066 | Ultimate Health & Wellness, LLC | Naturopath | 2862 Whitehall Blvd, Whitehall, WV 26554 | 2017-10-10 |
| 1457872376 | Michele R Lilley | Nurse Practitioner | 177 Middletown Rd, Ste1, Upc Whitehall Medical, Fairmont, WV 26554 | 2017-06-30 |
| 1477906154 | Rebecca Hayes-merrill | Counselor | 212 Adams St., 3rd Floor, Fairmont, WV 26554 | 2016-07-19 |
| 1790173417 | Dennis Michael Lynch | Counselor | 5 Turf Lane, Fairmont, WV 26554 | 2015-01-05 |
| 1336558725 | Nicole Savage | Home Health Aide | 122 Abbott St, Fairmont, WV 26554 | 2014-08-11 |
| 1124434550 | Achuta Ram Aynampudi | Psychiatry & Neurology | 100 Stoney Hill Rd, Fairmont, WV 26554 | 2014-07-07 |
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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 |
|---|---|---|---|---|
| 1013096213 | Pediatric Partners, Pllc | Pediatrics | 312 10th St, Fairmont, WV 26554-3611 | 2006-11-06 |
| 1376863431 | Sarah Lynn Hall | Pediatrics | 1322 Locust Ave, Fairmont, WV 26554-1436 | 2010-06-10 |
| 1700016235 | Seeta Ram R Vangala | Pediatrics | 1322 Locust Ave, Fairmont, WV 26554-1436 | 2009-07-17 |
| 1972672061 | Thomas Wesley Steele | Pediatrics | 312 10th St, Fairmont, WV 26554-3611 | 2006-11-06 |
| 1578632667 | Babu R. Devabhakthuni | Pediatrics | 312 10th St, Fairmont, WV 26554-3611 | 2006-11-06 |
| 1700955804 | Sree K.p. Mulpuru | Pediatrics | 312 10th St, Fairmont, WV 26554-3611 | 2006-11-06 |
| 1275572695 | Deborah J Hiltz | Pediatrics | 1322 Locust Ave, Fairmont, WV 26554 | 2006-06-05 |
| 1225092638 | Agnes Marie Franz | Pediatrics | 1322 Locust Ave, Fairmont, WV 26554 | 2006-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902404395 | Williamson Health & Wellness Center, Inc | Pediatrics | 859 Alderson St Ste 4000, Williamson, WV 25661-3215 | 2020-10-16 |
| 1770127516 | Nicole Danielle Clendenin | Pediatrics | 314 Goff Mountain Rd Ste 16, Charleston, WV 25313-6600 | 2019-11-05 |
| 1760914691 | Bradley Gilbert Marple | Pediatrics | 401 6th Ave Ste 101, Montgomery, WV 25136-2116 | 2017-03-30 |
| 1447645007 | Jordan Beckett | Pediatrics | 414 Grand Park Dr Ste 1, Parkersburg, WV 26105-4065 | 2015-03-31 |
| 1235489931 | Spring Mills Medical Center | Pediatrics | 1179 T J Jackson Dr, Falling Waters, WV 25419-4698 | 2012-09-11 |
| 1982963278 | Lauren M Thompson | Pediatrics | 179 Station Pl, Suite 200, Hurricane, WV 25526-6578 | 2012-05-08 |
| 1215203500 | Valley Health Systems, Inc. | Pediatrics | 5b Rr 2, Poca, WV 25159-9601 | 2012-03-30 |
| 1609142983 | Valley Health Systems, Inc. | Pediatrics | 2550 Us Route 60, Hurricane, WV 25526-9436 | 2012-03-30 |
| 1154697431 | Valley Health Systems, Inc. | Pediatrics | 1246 Mcclellan Hwy, Harts, WV 25524 | 2012-03-30 |
| 1124303151 | Samuel P Rojas Md Inc | Pediatrics | 143 1/2 Stollings Ave, Logan, WV 25601-4010 | 2011-10-21 |
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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.