NPIMap

Individual provider Active NPI

Chandra Prabha, M.D.

  • Internal Medicine Physician
  • Norfolk, NE
National Provider Identifier
1376587592
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
23389 Issued in NE
Practice address
110 N 29TH St
Ste. 302
Norfolk, NE 68701-4461
Phone
(402) 844-8190
Fax
(402) 844-8191
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 23389 NE Primary

Addresses

Primary practice location

110 N 29TH St
Ste. 302
Norfolk, NE 68701-4461

Mailing address

110 N 29TH St
Ste. 302
Norfolk, NE 68701-4461
Phone (402) 844-8190

Other identifiers 3

IdentifierTypeStateIssuer
P00255285OtherNERR
247335OtherNEMIDLANDS CHOICE
30075OtherNEBCBSNE

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

State licenses

LicenseStateTypeSpecialty
23389NEMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Regional Physician Services, LLC Past Accepting new patients
Spectrum Medical Associates LLC Internal Medicine Past Accepting new patients
University Geriatrics & Internal Medicine Associates,LLC Internal Medicine Past Accepting new patients
Faith Regional Physician Services, LLC Internal Medicine PastSince Sep 30, 2015 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1376587592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N 29TH ST",
            "address_2": "STE. 302",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014461",
            "telephone_number": "402-844-8190",
            "fax_number": "402-844-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N 29TH ST",
            "address_2": "STE. 302",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014461",
            "telephone_number": "402-844-8190",
            "fax_number": "402-844-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHA",
        "first_name": "CHANDRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "23389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR",
            "identifier": "P00255285",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "247335",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNE",
            "identifier": "30075",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; 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.