Healthcare Provider Details

I. General information

NPI: 1497549216
Provider Name (Legal Business Name): ADULTPED INTEGR PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2616 S MINNESOTA AVE SUITE 5
SIOUX FALLS SD
57105
US

IV. Provider business mailing address

2616 S MINNESOTA AVE SUITE 5
SIOUX FALLS SD
57105
US

V. Phone/Fax

Practice location:
  • Phone: 606-323-7976
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VINOD S BHATARA
Title or Position: OWNER
Credential: MD
Phone: 605-323-7976