Gary L Prah, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01026342A Issued in IN

Practice address

1318 Main St
Lafayette, IN 47901-1550

Phone

(765) 742-5254

Fax

(765) 742-4991

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Athens Medical Group LLC

  • Family Medicine Physician
  • Crawfordsville, IN
  • NPI 1043444714

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1215906235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4699",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479034699",
            "telephone_number": "765-449-2732",
            "fax_number": "765-449-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 MAIN ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479011550",
            "telephone_number": "765-742-5254",
            "fax_number": "765-742-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAH",
        "first_name": "GARY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01026342A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100231570",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000107537",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "garyprah@idx.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1318 Main St",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479011550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kyrie Potter, LAT, ATC
• Shruti Singh Poulsen, PH.D.
• Claire Powell
• Stephen Powell, D.D.S., M.S.D.
• Allison Powers
• Pranav Prakash, M.D.
• Torri S Predmore, PA-C
• Chelsea Preiss, CNS
• Premise Health of Indiana Medical, P.C.
• Alyssa Deanne Prescott, RN, BSN

• Internal Medicine Physician in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.