Healthcare Provider Details

I. General information

NPI: 1871882290
Provider Name (Legal Business Name): VIJAY RAVIPATI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2011
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 E BROAD ST
COLUMBUS OH
43213-1502
US

IV. Provider business mailing address

6965 HANBYS LOOP
NEW ALBANY OH
43054-7542
US

V. Phone/Fax

Practice location:
  • Phone: 614-234-6000
  • Fax:
Mailing address:
  • Phone: 402-595-8865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35.138565
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: