Sivaprasad Parnam, PT

Individual provider Active NPI Nursing Facility/Intermediate Care Facility · West Lafayette Bra, IN

NPI 1164529715 · NPPES record last updated Sep 11, 2025

Key facts

NPI
1164529715
Entity type
Individual (NPI type 1)
Primary specialty
Nursing Facility/Intermediate Care Facility 313M00000X
License
05009075A (IN)
Practice address
3401 Soldiers Home Rd
West Lafayette Bra, IN 47906-1222
Phone
(765) 463-1541
NPI assigned
Sep 17, 2006
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
028303NYMDPhysical Therapist
05009075AINMDNursing Facility/Intermediate Care Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Shiva Physical Therapy LLC Physical Therapist Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 028303 NY
Nursing Facility/Intermediate Care Facility 313M00000X 05009075A IN Yes

Addresses

Primary practice location

3401 Soldiers Home Rd
West Lafayette Bra, IN 47906-1222

Mailing address

2601 Soldiers Home Rd
West Lafayette Bra, IN 47906-1653
Phone (203) 517-5022

Other providers in West Lafayette Bra, IN

All providers in West Lafayette Bra, IN · Nursing Facility/Intermediate Care Facility in Indiana

Sources for this page

Verify at the official NPI Registry.