Prathap Bandipalliam, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

43267 Issued in KY

Practice address

2688 Pink Pigeon Pkwy
225
Lexington, KY 40509-2258

Phone

(646) 884-2611

NPI assigned

Jul 23, 2014

Last updated

Jan 23, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1114335049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2688 PINK PIGEON PKWY",
            "address_2": "#225,",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092258",
            "telephone_number": "646-884-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2688 PINK PIGEON PKWY",
            "address_2": "225",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092258",
            "telephone_number": "646-884-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDIPALLIAM",
        "first_name": "PRATHAP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-23",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "43267",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "40576",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301067795",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boboto Balonda
• Amanda Balow
• Grace Baltenberger, PHARMD
• John E Balthrop, MD
• Jackie L Banahan, D.M.D.
• Tenley Bands
• Wendy Elizabeth Banfi, M.D.
• Zainub Bangash
• Genesis Song Bangha, CRNA
• Tara Bangtson, LPCA

• Internal Medicine Physician in Lexington, KY
• Providers in Lexington, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.

Verify at the official NPI Registry.