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General NPI Number Information
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NPI Number | 1497549216
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Entity Type | Organization
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Legal Business Name | ADULTPED INTEGR PSYCHIATRY
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 2616 S MINNESOTA AVE SUITE 5
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City | SIOUX FALLS
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State | SD
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Zip | 57105
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Country | US
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Telephone | 606-323-7976
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Fax |
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Provider Business Mailing Address
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Address Line | 2616 S MINNESOTA AVE SUITE 5
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City | SIOUX FALLS
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State | SD
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Zip | 57105
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. VINOD S BHATARA
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Credential | MD
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Telephone | 605-323-7976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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