NPIMap

Organization Active NPI

Kabindra N Mishra MD PC

  • Specialist
  • Jackson, MI
National Provider Identifier
1659549228
Registry record updated Feb 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
KM033204 Issued in MI
Legal business name
KABINDRA N MISHRA MD PC
Practice address
1100 E Michigan Ave
Suite 308
Jackson, MI 49201-1847
Phone
(517) 787-3900
NPI assigned
Feb 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2008

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

Authorized official

Name
Dr. Kabindra N Mishra, MDNPI 1528050721
Title
Owner
Phone
(517) 787-3900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X KM033204 MI Primary

Addresses

Primary practice location

1100 E Michigan Ave
Suite 308
Jackson, MI 49201-1847

Mailing address

1100 E Michigan Ave
Suite 308
Jackson, MI 49201-1847
Phone (517) 787-3900

Other identifiers 4

IdentifierTypeStateIssuer
2105656MedicaidMI
P58871OtherMIBLUE CARE NETWORK
1196630001OtherMIMEDICARE DMERC
2003811701OtherMIBCBSM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1659549228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E MICHIGAN AVE",
            "address_2": "SUITE 308",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011847",
            "telephone_number": "517-787-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E MICHIGAN AVE",
            "address_2": "SUITE 308",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011847",
            "telephone_number": "517-787-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KABINDRA N MISHRA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "MISHRA",
        "authorized_official_first_name": "KABINDRA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-787-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "KM033204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105656",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P58871",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC",
            "identifier": "1196630001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "2003811701",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.