Active NPI
Karl D Pryor Jr., MD
- Pediatrics Physician
- Indianapolis, IN
National Provider Identifier
1053491415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01068714A
- Practice address
- 3401 E Raymond St
Indianapolis, IN 46203-4744 - Phone
- (317) 957-2100
- Fax
- (317) 957-2120
- NPI assigned
- Oct 17, 2006
- Last updated
- Jul 24, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 40208 | KY | |
| Pediatrics Physician | 208000000X | 01068714A | IN | Primary |
Addresses
Primary practice location
3401 E Raymond St
Indianapolis, IN 46203-4744
Mailing address
3401 E Raymond St
Indianapolis, IN 46203-4744
Phone (317) 957-2100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200994200 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01068714A | IN | MD | Pediatrics Physician |
| 40208 | KY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Past | Accepting new patients | |
| Healthnet, Inc. | Past | Accepting new patients |
Interoperability endpoints
- karl.pryor@hn.eclinicaldirectplus.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Federally Qualified Health Center (FQHC)
- Indianapolis, IN
- NPI 1780634964
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437696000000",
"number": "1053491415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 E RAYMOND ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462034744",
"telephone_number": "317-957-2100",
"fax_number": "317-957-2120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 E RAYMOND ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462034744",
"telephone_number": "317-957-2100",
"fax_number": "317-957-2120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRYOR",
"first_name": "KARL",
"middle_name": "D",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2015-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KY",
"license": "40208",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01068714A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200994200",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.