Individual provider Active NPI

Divya Vodikad Jaiprakash, MD

  • Internal Medicine Physician
  • Harrisburg, PA
National Provider Identifier
1861653552
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD454073 Issued in PA
Practice address
4230 Crums Mill Rd
Harrisburg, PA 17112-2898
Phone
(717) 233-6171
NPI assigned
Jun 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD454073 PA Primary

Addresses

Primary practice location

4230 Crums Mill Rd
Harrisburg, PA 17112-2898

Mailing address

205 Grandview Ave
Suite 210
Camp Hill, PA 17011-1708
Phone (717) 972-7917

Other names 1

  • Divya V J Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171011000568 NC Practitioner - Internal MedicinePractitioner - Family Practice 1355669656 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians, Inc. Internal Medicine CurrentSince Sep 1, 2017 Accepting new patients
Duke University Affiliated Physicians, Inc. Internal Medicine CurrentSince Sep 1, 2017 Accepting new patients
Duke University Affiliated Physicians, Inc. Internal Medicine Current Accepting new patients

Locations

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

1901 Hillandale Rd
Ste D
Durham, NC 27705
Phone (919) 383-4355

10211 Alm St
Ste 1100
Raleigh, NC 27617
Phone (919) 385-1160

7200 Creedmoor Rd
Ste 208
Raleigh, NC 27613
Phone (919) 327-1650

3320 Wake Forest Rd
Ste 310
Raleigh, NC 27609
Phone (919) 855-8911

7021 Harps Mill Rd
Ste 100
Raleigh, NC 27615
Phone (919) 576-8480

Interoperability endpoints

  • Direct secure messaging: divya.vj.1@18383.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1861653552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 GRANDVIEW AVE",
            "address_2": "SUITE 210",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170111708",
            "telephone_number": "717-972-7917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 CRUMS MILL RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171122898",
            "telephone_number": "717-233-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VODIKAD JAIPRAKASH",
        "first_name": "DIVYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD454073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIVYA",
            "last_name": "V J",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.