Subbanna Jayaprakash, M.D., S.C.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

27676 Issued in WI

Legal business name

SUBBANNA JAYAPRAKASH, M.D., S.C.

Practice address

6015 Durand Ave
500
Racine, WI 53406-5089

Phone

(262) 598-1001

NPI assigned

Feb 15, 2006

Organization subpart

No

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

Authorized official

Name

Subbanna Jayaprakash, M.D.

Title

Owner

Phone

(262) 598-1001

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Rehabilitation Physicians of Racine Doing business as

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477527380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 DURAND AVE",
            "address_2": "500",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534065089",
            "telephone_number": "262-598-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 DURAND AVE",
            "address_2": "500",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534065089",
            "telephone_number": "262-598-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBBANNA JAYAPRAKASH, M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JAYAPRAKASH",
        "authorized_official_first_name": "SUBBANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-598-1001",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "27676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32783300",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31477200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rehabilitation Physicians of Racine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard Stoltenberg, MD
• Elyssa Strangberg
• Strategic Transit Service LLC
• Kristine Stratman
• Richard Jay Stultz, DDS
• Nancy Carla Sullivan, LPN
• Sean Patrick Sullivan, RN
• Steven J Suokko, PHARMACIST
• Surgicenter of Racine LTD
• Vincent R Susini, MD, DC, MSC

• Physical Medicine & Rehabilitation Physician in Racine, WI
• Providers in Racine, WI by specialty
• Physical Medicine & Rehabilitation Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.