Radhika Prakash, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0041524 Issued in FL

Legal business name

RADHIKA PRAKASH, MD

Practice address

2758 US S 1 South
St. Augustine, FL 32086

Phone

(904) 797-2338

Fax

(904) 797-2331

NPI assigned

Jan 8, 2015

Last updated

Jan 8, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Radhika PrakashNPI 1669482170

Title

MD

Phone

(904) 797-2338

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Radhika Prakash, MD

  • Internal Medicine Physician
  • St Augustine, FL
  • NPI 1669482170
  NPD (past) Authorized official
• Manoj Prakash, MD

  • Pulmonary Disease Physician
  • St Augustine, FL
  • NPI 1235149329
  NPD (past)

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

{
    "created_epoch": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420675200000",
    "number": "1164810503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860120",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320860120",
            "telephone_number": "904-797-2338",
            "fax_number": "904-797-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2758 US S 1 SOUTH",
            "city": "ST. AUGUSTINE",
            "state": "FL",
            "postal_code": "32086",
            "telephone_number": "904-797-2338",
            "fax_number": "904-797-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADHIKA PRAKASH, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2015-01-08",
        "status": "A",
        "authorized_official_last_name": "PRAKASH",
        "authorized_official_first_name": "RADHIKA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "904-797-2338"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0041524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "55118",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009180500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Shannon Quilty
• Morgan Quinn
• Jeannette Quinones, PHARM D
• Marina Rabkin, MD
• Catherine Suzanne Rada, PT
• Radiology Imaging Associates LLC
• Radiology Imaging Associates LLC
• Radiology Imaging Associates, LLC
• Radiology Imaging Associates, LLC
• Radiology Imaging Associates, LLC

• Internal Medicine Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.