Individual provider Active NPI

Prakash B Patel, MD

  • Gastroenterology Physician
  • St Joseph, MO
National Provider Identifier
1497778682
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
R3A80 Issued in MO
Practice address
1011 E Saint Maartens Dr
St Joseph, MO 64506
Phone
(816) 232-0185
Fax
(816) 364-6225
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X R3A80 MO Primary

Addresses

Primary practice location

1011 E Saint Maartens Dr
St Joseph, MO 64506

Mailing address

1011 E Saint Maartens Dr
St Joseph, MO 64506
Phone (816) 232-0185

Other identifiers 1

IdentifierTypeStateIssuer
201272606MedicaidMO

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1497778682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 E SAINT MAARTENS DR",
            "city": "ST JOSEPH",
            "state": "MO",
            "postal_code": "64506",
            "telephone_number": "816-232-0185",
            "fax_number": "816-364-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 E SAINT MAARTENS DR",
            "city": "ST JOSEPH",
            "state": "MO",
            "postal_code": "64506",
            "telephone_number": "816-232-0185",
            "fax_number": "816-364-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRAKASH",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "R3A80",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201272606",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.