SASIDHARAN TARAVATH (NPI# 1851353718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851353718 |
| Entity Type | Individual |
| Full Name | SASIDHARAN TARAVATH |
| Credential | MD |
| Practice Address |
2131 S 17th St Wilmington NC 28401-7407 |
| Practice Telephone | 9107729202 |
| Practice Fax Number | 9107729452 |
| Mailing Telephone | 9107729202 |
| Mailing Fax Number | 9107729452 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2014-02-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0008X |
Pediatrics Specialization: Neurodevelopmental Disabilities |
999999 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 0090530000 | 05 |
| Street Address |
2131 S 17TH ST |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28401-7407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992708747 | Wilmington Anesthesiologists Pllc | Anesthesiology | 2131 S 17th St, Wilmington, NC 28401-7407 | 2005-05-24 |
| 1316548159 | Thomas Martin Leighton | Nurse Practitioner | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-11-06 |
| 1902406176 | Jeff Marsh | Registered Nurse | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-10-27 |
| 1629685664 | Bobbie Sheatsley | Nurse Anesthetist, Certified Registered | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-09-24 |
| 1699393504 | Megan Grogan | Nurse Anesthetist, Certified Registered | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-07-07 |
| 1215556550 | Salman Khan | Student in an Organized Health Care Education/Training Program | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-04-15 |
| 1760001028 | John William Miller Jr. | Student in an Organized Health Care Education/Training Program | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-04-15 |
| 1588283246 | Amanda Kristin Briese | Student in an Organized Health Care Education/Training Program | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-04-13 |
| 1689293300 | Broc D Astill | Student in an Organized Health Care Education/Training Program | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-04-13 |
| 1467071423 | Siten Patel | Student in an Organized Health Care Education/Training Program | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275002461 | Thrivetothrive, LLC | Physical Therapist | 1606 Physicians Drive, Inside Promina Health, Wilmington, NC 28401 | 2018-11-16 |
| 1841787454 | Kevin Christopher Panebianco | Family Medicine | 1911 S 17th St Ste 130a, Wilmington, NC 28401 | 2018-04-18 |
| 1518472588 | Michelle Bruin | Family Medicine | 415 S. 2nd Street, Wilmington, NC 28401 | 2017-12-12 |
| 1639617343 | Anna Farwell | Behavior Technician | 3904 Oleander Dr. Suite 102, Wilmington, NC 28401 | 2017-02-02 |
| 1588034144 | Dimitri Zivko Pitovski | Allergy & Immunology | 1099 Medical Center Dr Unit 100b, Wilmington, NC 28401 | 2015-09-25 |
| 1629457007 | Megan Havel | Counselor | 1512 E Lakeshore Drive, Wilmington, NC 28401 | 2015-05-19 |
| 1154709251 | Lance Hutchens | Dentist | 1611 Doctors Cir, Wilmington, NC 28401 | 2015-05-11 |
| 1609281161 | Diane Pittman Whitford | Counselor | 313 Walnut St., Wilmington, NC 28401 | 2014-06-24 |
| 1942550728 | Bryan Cole Chalk | Nurse Anesthetist, Certified Registered | 2131 S 17th Street, Wilmington, NC 28401 | 2012-09-19 |
| 1740566546 | Valerie Baars | Pharmacist | 2302 S 17th Street, Wilmington, NC 28401 | 2011-10-25 |
| Find all providers in zip 28401 | ||||
| Taxonomy Code | 2080P0008X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neurodevelopmental Disabilities |
| A pediatrician who treats children having developmental delays or learning disorders including those associated with visual and hearing impairment, mental retardation, cerebral palsy, spina bifida, autism and other chronic neurologic conditions. This specialist provides medical consultation and education and assumes leadership in the interdisciplinary management of children with neurodevelopmental disorders. They may also focus on the early identification and diagnosis of neurodevelopmental disabilities in infants and young children as well as on changes that occur as the child with developmental disabilities grows. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902081664 | Marianne Camille San Antonio | Pediatrics | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2007-12-31 |
| 1558314880 | Beth Parrish | Pediatrics | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427186113 | Thomas A St John | Pediatrics | 70 Holly Ln, Brevard, NC 28712-4783 | 2007-03-02 |
| 1699816017 | Liya Beyderman | Pediatrics | 6115 Park South Dr Ste 105, Charlotte, NC 28210-0104 | 2007-02-09 |
| 1467505016 | Cmc-northeast, Inc | Pediatrics | 16623 Birkdale Pwky, Suite 110, Ne Pediatric Neuro, Huntersville, Huntersville, NC 28078 | 2007-01-18 |
| 1013040666 | Shana Dale Wallace | Pediatrics | 1900 Randolph Rd, Suite 1010, Charlotte, NC 28207-1122 | 2007-03-13 |
| 1992734263 | Kristi L. Milowic | Pediatrics | 1520 Sunday Dr, Raleigh, NC 27607-5253 | 2006-06-30 |
| 1366409492 | Novant Medical Group, Inc | Pediatrics | 1900 Randolph Road, Suite 1010, Charlotte, NC 28207-1117 | 2006-05-01 |
| 1548230493 | Herminia De Guzman Ferreras | Pediatrics | 100 Medical Park Dr, Suite 310, Concord, NC 28025-2966 | 2006-01-24 |
| City | WILMINGTON |
| Zip Code | 28401 |
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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.