RATHNA SREE MALLELA M.D. M.P.H. NPI 1194043554

NPI Information

NPI: 1194043554
Provider Name: RATHNA SREE MALLELA, M.D., M.P.H.
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Individual

Specialization: Child & Adolescent Psychiatry

Address:
2600 HUMES RD STE 100
JANESVILLE, WI
ZIP 53545
Phone: (608) 741-2117
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Rathna Sree Mallela, M.D., M.P.H. is a child and adolescent psychiatry psychiatry neurology in Janesville, WI. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. Rathna Sree Mallela, M.D., M.P.H. NPI is 1194043554. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2600 HUMES RD STE 100
JANESVILLE, WI
ZIP 53545-491
Phone: (608) 741-2117
Fax: (608) 758-5761

The enumeration date for this NPI number is 5/11/2010 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	64316-20	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1194043554	OTHER	WISCONSIN	DEANHEALTH PLAN
2	1194043554	MEDICAID	WISCONSIN
3	K400258434-00084908	OTHER	WISCONSIN	WI MEDICARE
4	K400258432-000054176	OTHER	WISCONSIN	WI MEDICARE
5	MALLERAT	OTHER	WISCONSIN	MERCYCARE INSURANCE
6	1194043554	OTHER	WISCONSIN	BCBSWI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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