DR. VENKATA MOHAN RAJU LAKKIMSETTY (NPI# 1679781793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679781793 |
| Entity Type | Individual |
| Full Name | DR. VENKATA MOHAN RAJU LAKKIMSETTY |
| Credential | MD |
| Practice Address |
1 Freedom Way Charlie Norwood Augusta Va Augusta GA 30904 |
| Practice Telephone | 7067330188 |
| Mailing Telephone | 7067330188 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2012-02-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
101816 | FL | Allopathic & Osteopathic Physicians |
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
067138 | GA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1 FREEDOM WAY CHARLIE NORWOOD AUGUSTA VA |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912900713 | Robert Leon Longe | Pharmacist | 1 Freedom Way, Augusta, GA 30904-6258 | 2005-05-24 |
| 1609476951 | Melissa Ann Cotton | Dentist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-27 |
| 1487253217 | Kelsey Shull | Recreation Therapist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-22 |
| 1437758844 | Angela Marie Brown | Social Worker | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-19 |
| 1538767819 | Stephen William Montgomery | Music Therapist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-09 |
| 1134726631 | Rebecca Leigh Halioua | Recreation Therapist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-07 |
| 1104435718 | Vincent Michael Fitch | Psychologist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-07-29 |
| 1558988162 | Amanda Draheim | Psychologist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-06-30 |
| 1174140784 | Tiffany Ariel Graves | Student in an Organized Health Care Education/Training Program | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-06-30 |
| 1982221776 | Janice J Anglin | Dietitian, Registered | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1124552690 | Jenny Liles | Student in an Organized Health Care Education/Training Program | 1004 Chafee Ave, Augusta, GA 30904 | 2017-04-11 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| Find all providers in zip 30904 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700490091 | Interventional and Alternative Spine and Wellness, LLC | Physical Medicine & Rehabilitation | 3630 Wheeler Rd, Augusta, GA 30909-6561 | 2020-09-03 |
| 1396905816 | Royal Pain Center PC | Physical Medicine & Rehabilitation | 2922 Professional Pkwy Ste A, Augusta, GA 30907-6532 | 2008-06-10 |
| 1104884246 | John Martin Downey | Physical Medicine & Rehabilitation | 2922 Professional Pkwy, Ste A, Augusta, GA 30907-6528 | 2006-05-01 |
| 1215201355 | Augusta Interventional Pain and Rehabilitation | Physical Medicine & Rehabilitation | 1355 Independence Dr, Augusta, GA 30901-1037 | 2012-03-07 |
| 1447541446 | Joseph Augustin Md LLC | Physical Medicine & Rehabilitation | 3540 Wheeler Rd, Suite 508, Augusta, GA 30909-1871 | 2011-04-25 |
| 1295904050 | Joseph Charles Augustin | Physical Medicine & Rehabilitation | 1355 Independence Dr, Physician Suite, Augusta, GA 30901-1037 | 2008-02-26 |
| 1063699015 | John M Downey | Physical Medicine & Rehabilitation | 2922 Professional Pkwy, Suite A, Augusta, GA 30907-6528 | 2008-01-22 |
| 1326115411 | John M Downey Sr Do PC | Physical Medicine & Rehabilitation | 2922 Professional Pkwy, Augusta, GA 30907-6528 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205151 | Georgia Regenrx, LLC. | Physical Medicine & Rehabilitation | 5755 N Point Pkwy Ste 72, Alpharetta, GA 30022-1146 | 2020-08-11 |
| 1710514989 | Jennifer Meyer | Physical Medicine & Rehabilitation | 1554 Riverstone Pkwy Ste 160, Canton, GA 30114-2887 | 2020-03-26 |
| 1982172060 | Back To Life Pain Center, LLC | Physical Medicine & Rehabilitation | 410 Creekstone Rdg, Woodstock, GA 30188-3740 | 2018-11-07 |
| 1760900708 | Neuro Diagnostic Group LLC | Physical Medicine & Rehabilitation | 200 Galleria Pkwy Se Ste 100, Atlanta, GA 30339-5944 | 2017-08-30 |
| 1386195378 | Pain Management and Rehabilitation | Physical Medicine & Rehabilitation | 4121 Steve Reynolds Blvd, Norcross, GA 30093-3060 | 2016-10-14 |
| 1124471172 | Pain Management and Rehabilitation | Physical Medicine & Rehabilitation | 4131 Steve Reynolds Blvd, Norcross, GA 30093-3060 | 2016-07-14 |
| 1043671761 | Pain Management and Rehabilitation Inc | Physical Medicine & Rehabilitation | 3955 Lawrenceville Hwy Nw, Lilburn, GA 30047-2996 | 2016-03-08 |
| 1356761191 | Simon Matt Willis | Physical Medicine & Rehabilitation | 114 Canal St Ste 503, Pooler, GA 31322-4261 | 2014-04-20 |
| 1891139663 | Advanced Pain and Rahabilitation PC | Physical Medicine & Rehabilitation | 3030 Mcever Rd Ste 300, Gainesville, GA 30504-5538 | 2013-04-24 |
| 1013261312 | Tattnall Hospital Company, LLC | Physical Medicine & Rehabilitation | 8. North Williams Street, Metter, GA 30439 | 2012-11-08 |
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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.