Individual provider Active NPI

Elizabeth J Prabhakar, P.T

  • Physical Therapist
  • Indianapolis, IN
National Provider Identifier
1497966121
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05008217A Issued in IN
Practice address
8616 W 10TH St
Indianapolis, IN 46234-2167
Phone
(317) 209-2332
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05008217A IN Primary

Addresses

Primary practice location

8616 W 10TH St
Indianapolis, IN 46234-2167

Mailing address

10852 Riva Ridge CT
Indianapolis, IN 46234-9689
Phone (317) 272-5008

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

State licenses

LicenseStateTypeSpecialty
05008217AINMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497966121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10852 RIVA RIDGE CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462349689",
            "telephone_number": "317-272-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8616 W 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462342167",
            "telephone_number": "317-209-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHAKAR",
        "first_name": "ELIZABETH",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05008217A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.