Active NPI
Chandrama Chakrabarti, MD
- Pediatrics Physician
- Terre Haute, IN
National Provider Identifier
1073593034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01050624A
- Practice address
- 4525 Springhill Junction
Terre Haute, IN 47802 - Phone
- (812) 234-6053
- Fax
- (812) 478-3416
- NPI assigned
- Jan 18, 2006
- Last updated
- Mar 12, 2010
- Sex
- Female
- 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 | 01050624A | IN | Primary |
| Pediatric Infectious Diseases Physician | 2080P0208X | 01050624A | IN |
Addresses
Primary practice location
4525 Springhill Junction
Terre Haute, IN 47802
Mailing address
4525 Springhill Junction
Terre Haute, IN 47802
Phone (812) 234-6053
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000244694 | Other | BLUE CROSS PROVIDER # | |
| 200414010 | 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 |
|---|---|---|---|
| 01050624A | IN | MD | Pediatric Infectious Diseases Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Union Hospital Inc. | Current | Accepting new patients |
Interoperability endpoints
- 017442@unionhealth.cernerdirect.com
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Terre Haute, IN
- NPI 1619975331
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268352000000",
"number": "1073593034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4525 SPRINGHILL JUNCTION",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "47802",
"telephone_number": "812-234-6053",
"fax_number": "812-478-3416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4525 SPRINGHILL JUNCTION",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "47802",
"telephone_number": "812-234-6053",
"fax_number": "812-478-3416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAKRABARTI",
"first_name": "CHANDRAMA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-18",
"last_updated": "2010-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01050624A",
"primary": true
},
{
"code": "2080P0208X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Infectious Diseases",
"state": "IN",
"license": "01050624A",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER #",
"identifier": "000000244694",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200414010",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Terre Haute, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.