1316694318 NPI number — TAKES A VILLAGE II

Table of content: DR. REKHA HARI NAIR M.D. (NPI 1013119221)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316694318 NPI number — TAKES A VILLAGE II

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TAKES A VILLAGE II
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316694318
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1442
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOPEWELL
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23860-1442
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13010 MORRIS RD STE 650
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALPHARETTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30004-5197
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-400-8839
Provider Business Practice Location Address Fax Number:
804-800-4483
Provider Enumeration Date:
03/09/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JENKINS
Authorized Official First Name:
LA-TOYA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR/ CLINICIAN
Authorized Official Telephone Number:
804-404-8241

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)