Active NPI
Rafik Farag, MD
- Family Medicine Physician
- Peru, IN
National Provider Identifier
1629208251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01021342A
- Practice address
- 1694 W Logansport Rd.
Community Health Center of Miami County
Peru, IN 46970 - Phone
- (765) 472-2519
- Fax
- (765) 472-3192
- NPI assigned
- Jul 16, 2009
- Last updated
- Jul 6, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01021342A | IN | Primary |
Addresses
Primary practice location
1694 W Logansport Rd.
Community Health Center of Miami County
Peru, IN 46970
Mailing address
8003 Castleway Drive
Indiana Health Centers, Inc.
Indianapolis, IN 46250
Phone (317) 576-1335
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21342 | OH | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana Health Centers Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Federally Qualified Health Center (FQHC)
- Indianapolis, IN
- NPI 1942303086
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309910400000",
"number": "1629208251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8003 CASTLEWAY DRIVE",
"address_2": "INDIANA HEALTH CENTERS, INC.",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "46250",
"telephone_number": "317-576-1335",
"fax_number": "317-576-1339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1694 W LOGANSPORT RD.",
"address_2": "COMMUNITY HEALTH CENTER OF MIAMI COUNTY",
"city": "PERU",
"state": "IN",
"postal_code": "46970",
"telephone_number": "765-472-2519",
"fax_number": "765-472-3192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARAG",
"first_name": "RAFIK",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-16",
"last_updated": "2011-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01021342A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peru, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.