Pra Medical Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

01027483A Issued in IN

Legal business name

PRA MEDICAL INC

Practice address

211 N Eddy St
South Bend, IN 46617-2808

Phone

(574) 299-2450

Fax

(574) 273-6546

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Yupida Prasertwanitch, MD

Title

Owner

Phone

(574) 273-6546

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Yupadi Prasertwanitch, MD

  • Anesthesiology Physician
  • South Bend, IN
  • NPI 1376524884
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770613622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 182",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465460182",
            "telephone_number": "574-273-6546",
            "fax_number": "574-273-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172808",
            "telephone_number": "574-299-2450",
            "fax_number": "574-273-6546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRA MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRASERTWANITCH",
        "authorized_official_first_name": "YUPIDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-273-6546",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IN",
            "license": "01027483A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EIN",
            "identifier": "3521474218",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Robinson Pounds, MD
• Brian Powell
• John F Powell, M.D.
• Katherine S Powell, MS
• Powell'S Precious Lotus LLC
• Joseph Prahlow, M.D.
• Candice Pranger
• Yupadi Prasertwanitch, MD
• Claudia Pratt, MSW
• Precious Pals Inc

• Specialist in South Bend, IN
• Providers in South Bend, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.