DR. AJAY REDDIVARI (NPI# 1063494086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063494086 |
| Entity Type | Individual |
| Full Name | DR. AJAY REDDIVARI |
| Credential | M.D. |
| Practice Address |
1380 E Stroop Rd Kettering OH 45429-4926 |
| Practice Telephone | 9372944356 |
| Practice Fax Number | 9372972381 |
| Mailing Telephone | 9372944356 |
| Mailing Fax Number | 9372972381 |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2019-01-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
35-06-0503R | OH | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
35060503 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0941600 | 05 |
| Street Address |
1380 E STROOP RD |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-4926 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902208309 | Jacob D Sillaman | Physician Assistant | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2014-09-17 |
| 1821342320 | Sarah Christine Gibble | Physician Assistant | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2012-11-05 |
| 1013288166 | Amanda Yun Anania | Physician Assistant | 1380 E Stroop Rd, Kettering, OH 45429 | 2012-01-21 |
| 1396049011 | Ryan Stewart Clark | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2011-01-10 |
| 1144532409 | Mohammed O Ali | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2010-07-02 |
| 1720106685 | Nathaniel Joseph Dittoe | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2007-03-27 |
| 1750432811 | Cardiology South | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2007-01-16 |
| 1306864608 | Mark W Moronell | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429 | 2006-07-17 |
| 1669456943 | Robert Woodrow Kiefaber | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2005-12-01 |
| 1023091501 | Calvert Raymond Busch | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2005-11-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821576414 | Lauren Danielle Sivley | Nurse Practitioner | 3535 Sourthern Boulevard, Kettering, OH 45429 | 2018-08-06 |
| 1114446127 | Louai Al-samkari | Chiropractor | 1441 E. Stroop Rd., Kettering, OH 45429 | 2017-09-12 |
| 1407373756 | Benjamin Edward Adkins | Specialist/Technologist | 4116 Vinita Dr., Kettering, OH 45429 | 2017-08-28 |
| 1972036341 | James Kim | Student in an Organized Health Care Education/Training Program | 3535 Southern Boulevard, Kettering, OH 45429 | 2017-04-04 |
| 1023549847 | Adrienne Krysiak | Emergency Medicine | 3525 Southern Boulevard, Kettering, OH 45429 | 2017-03-23 |
| 1386021889 | Cassandra Mckoy | Counselor | 529 East Stroop Road, Kettering, OH 45429 | 2015-05-04 |
| 1417343088 | Candace Benoit | Obstetrics & Gynecology | 3533 Southern Blvd Ste 4600, Dayton, OH 45429 | 2015-04-10 |
| 1275933574 | Lee Schwieterman | Nurse Practitioner | 3535 Southern Blvd., 1 East, Kettering, OH 45429 | 2014-08-25 |
| 1497161947 | Robert Jonathon Fresch Jr. | Obstetrics & Gynecology | 3533 Southern Blvd Ste 3750, Kettering, OH 45429 | 2014-07-05 |
| 1821349812 | Lucas Brewer | Counselor | 1524 E Stroop Rd Ste 300, Kettering, OH 45429 | 2012-10-01 |
| Find all providers in zip 45429 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114282647 | Ashish Mahajan | Internal Medicine | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2012-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730799347 | Warren Endovascular Associates LLC | Internal Medicine | 1950 Niles Cortland Rd Ne Ste 12, Warren, OH 44484-1077 | 2020-08-07 |
| 1821570128 | Rishi Puri | Internal Medicine | 9500 Euclid Ave # J2-208, Cleveland, OH 44195-0001 | 2018-09-04 |
| 1760980049 | Cardiac Cin of Columbus LLC | Internal Medicine | 175 S 3rd St Ste 200-248, Columbus, OH 43215-5134 | 2018-01-31 |
| 1316445695 | Cardiac Cin of Cincinnati LLC | Internal Medicine | 9435 Waterstone Blvd Ste 140-302, Cincinnati, OH 45249-8226 | 2018-01-31 |
| 1720462591 | Midwest Access Services LLC | Internal Medicine | 7335 Yankee Rd Ste 101, Liberty Township, OH 45044-0008 | 2015-07-12 |
| 1306878863 | Medcentral Professional Association Inc. | Internal Medicine | 308 Glessner Ave, Mansfield, OH 44903-2225 | 2006-07-07 |
| 1629077961 | Gregory J Wood | Internal Medicine | 7200 Mentor Ave, Mentor, OH 44060-7522 | 2005-07-19 |
| 1508865213 | Joseph Michael Surmitis | Internal Medicine | 4082 Fulton Dr Nw, Canton, OH 44718-2866 | 2005-07-15 |
| 1851396428 | Puvi N Seshiah | Internal Medicine | 3219 Clifton Ave, Suite 400, Cincinnati, OH 45220-3027 | 2005-06-20 |
| 1669474839 | David G Bichsel | Internal Medicine | 745 W State St, Ste 750, Columbus, OH 43222-1515 | 2005-06-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. AJAY REDDIVARI.
| 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.