Active NPI
Prabhkar K Shetty, M.D.
- Specialist
- Gilford, NH
National Provider Identifier
1275517526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 4969
- Practice address
- 36 Country Club Rd
Gilford, NH 03249-6978 - Phone
- (603) 524-8020
- Fax
- (603) 527-0271
- NPI assigned
- Nov 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 4969 | NH | Primary |
Addresses
Primary practice location
36 Country Club Rd
Gilford, NH 03249-6978
Mailing address
PO Box 7392
Village West II
Laconia, NH 03247-7392
Phone (603) 524-8020
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 81183853 | Medicaid | NH | |
| 0103853Y0NH01 | Other | NH | ANTHEM BLUE CROSS |
| 6090 | Other | NH | CIGNA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389657600000",
"number": "1275517526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7392",
"address_2": "VILLAGE WEST II",
"city": "LACONIA",
"state": "NH",
"postal_code": "032477392",
"telephone_number": "603-524-8020",
"fax_number": "603-527-0271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 COUNTRY CLUB RD",
"city": "GILFORD",
"state": "NH",
"postal_code": "032496978",
"telephone_number": "603-524-8020",
"fax_number": "603-527-0271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHETTY",
"first_name": "PRABHKAR",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-30",
"last_updated": "2014-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NH",
"license": "4969",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "81183853",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "0103853Y0NH01",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "6090",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gilford, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.