Sudhir L Prabhu, M.D.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

ME 37408 Issued in FL

Practice address

4123 University Blvd S
B
Jacksonville, FL 32216-4371

Phone

(904) 636-9100

Fax

(904) 636-9102

NPI assigned

Sep 9, 2005

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

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HEHHBA
• FHIR API: https://fhir4.healow.com/fhir/r4/FCEFAA
• FHIR API: https://fhir4.healow.com/fhir/r4/IGJFCA

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.

• Family Allergy & Asthma Consultants

  • Specialist
  • Jacksonville, FL
  • NPI 1447312947
  Medicare reassignment NPD

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345680000000",
    "number": "1497749071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4123 UNIVERSITY BLVD S",
            "address_2": "B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164371",
            "telephone_number": "904-636-9100",
            "fax_number": "904-636-9102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 UNIVERSITY BLVD S",
            "address_2": "B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164371",
            "telephone_number": "904-636-9100",
            "fax_number": "904-636-9102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHU",
        "first_name": "SUDHIR",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2012-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "ME 37408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Lea Powlin, DPT, PT
• Wendy B Poxon
• Heather Marie Poynter, APRN
• Tiffany N Poynter, ATC, LAT
• Prasanna S Prabhu, MD
• Prac Holdings, Inc.
• Practical Neuropsychiatry Inc
• Practice Management Associates Jacksonville
• Ashutosh Ashok Pradhan, MD
• Sala R Pradhan, ARNP

• Allergy & Immunology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Allergy & Immunology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.