MS. REKHA NIDADAVOLU (NPI# 1902138217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902138217 |
| Entity Type | Individual |
| Full Name | MS. REKHA NIDADAVOLU |
| Other Name | DR. REKHA PINJALA |
| Credential | PHYSICIAN ASSISTANT |
| Practice Address |
4745 Old Canoe Creek Rd Saint Cloud FL 34769-1400 |
| Practice Telephone | 3059059316 |
| Mailing Telephone | 3059059316 |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2020-01-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | PS44664 | FL | Pharmacy Service Providers |
| N | 183500000X | Pharmacist | 24667 | MA | Pharmacy Service Providers |
| Y | 363A00000X | Physician Assistant | PA9111839 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | PHARMACIST LICENSE | 24667 | 01 |
| FL | FLORIDA PHYSICIAN ASSISTANT BOARD | PA9111839 | 01 |
| FL | FLORIDA BOARD OF PHARMACY | PS44664 | 01 |
| Street Address |
4745 OLD CANOE CREEK RD |
| City | SAINT CLOUD |
| State | FL |
| Zip Code | 34769-1400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124645742 | Angie Rojas | Nurse Practitioner | 4745 Old Canoe Creek Rd, Saint Cloud, FL 34769-1400 | 2020-06-30 |
| 1578922613 | Lake City Institute of Neurology Pa | Clinic/Center | 4745 Old Canoe Creek Rd, Saint Cloud, FL 34769-1400 | 2016-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053877506 | Premier Med Pa | Clinic/Center | 2906 17th St., St Cloud, FL 34769 | 2019-02-20 |
| 1760975387 | Mayra Rosado | Psychologist | Carrousel Therapy Center, 3201 Budinger Ave., Saint Cloud, FL 34769 | 2018-06-08 |
| 1598282113 | Salud Urgent Care LLC | Clinic/Center | 3107 13th Street, Saint Cloud, FL 34769 | 2017-08-24 |
| 1710332671 | American Healthcare Community Behavioral Services LLC | Social Worker | 1203 Florida Ave., St. Cloud, FL 34769 | 2016-04-28 |
| 1215395785 | Elite Garden | Assisted Living Facility | 4319 Neptune Road, St Cloud, FL 34769 | 2016-01-29 |
| 1336506732 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 4660 13th Street, St. Cloud, FL 34769 | 2016-01-15 |
| 1306202064 | Megan Rose Mcclave | Registered Nurse | 524 13th Street, St. Cloud, FL 34769 | 2016-01-12 |
| 1821473133 | Angela Creager | Counselor | 446 Hamilton Park Circle, St. Cloud, FL 34769 | 2015-07-28 |
| 1730574906 | Jordico LLC | Assisted Living Facility | 4417 13th Street, Suite 142, Saint Cloud, FL 34769 | 2015-04-03 |
| 1255731667 | Judimar Rodriguez | Behavioral Analyst | 1605 Eastern Ave, Saint Cloud, FL 34769 | 2014-09-04 |
| Find all providers in zip 34769 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598364473 | Kylee N Persing | Physician Assistant | 10 4th Ave S, Saint Cloud, MN 56301-3614 | 2020-10-21 |
| 1679110456 | Katelyn Bills | Physician Assistant | 3701 12th St N Ste 100, Saint Cloud, MN 56303-2253 | 2019-11-29 |
| 1285199307 | Jessica Brysky | Physician Assistant | 1900 Centracare Cir Ste 500, Saint Cloud, MN 56303-5000 | 2019-02-02 |
| 1013335801 | Natalia Becker | Physician Assistant | 1900 Centracare Cir # 500, Saint Cloud, MN 56303-5000 | 2014-03-31 |
| 1457507188 | Victor D Quinones | Physician Assistant | 3720 Cord Ave, Saint Cloud, FL 34772-8061 | 2008-08-13 |
| 1588647853 | Gerald Allen Taylor | Physician Assistant | 1510 24th Ave N, Saint Cloud, MN 56303-1304 | 2005-11-21 |
| 1023640034 | Faith Kelly Dammann | Physician Assistant | 1200 6th Ave N, Saint Cloud, MN 56303-2736 | 2020-02-07 |
| 1538707377 | Alissa Wigen | Physician Assistant | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2019-12-11 |
| 1952945560 | Amanda Rae Schwartz | Physician Assistant | 1900 Centracare Cir, Saint Cloud, MN 56303-5000 | 2019-11-06 |
| 1467095166 | Cameron Svihla | Physician Assistant | 1900 Centracare Cir, Saint Cloud, MN 56303-5000 | 2019-10-25 |
| Find all providers in SAINT CLOUD | ||||
| City | SAINT CLOUD |
| Zip Code | 34769 |
Please comment or provide details below to improve the information on MS. REKHA NIDADAVOLU.
| 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.