Provider Demographics
NPI:1497549216
Name:ADULTPED INTEGER
Entity type:Organization
Organization Name:ADULTPED INTEGER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINOD
Authorized Official - Middle Name:S
Authorized Official - Last Name:BHATARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-323-7976
Mailing Address - Street 1:2616 S MINNESOTA AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2616 S MINNESOTA AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105
Practice Address - Country:US
Practice Address - Phone:606-323-7976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADULTPED INTEGRATIVE PSYCHIATRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-07
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health