Active NPI
Prabhakar Venkatakrishinan, PT, DPT
- Physical Therapist
- Modesto, CA
National Provider Identifier
1891052189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 4601 Dale Rd
Modesto, CA 95356-9718 - Phone
- (209) 735-5000
- NPI assigned
- Apr 12, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | |||
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
4601 Dale Rd
Modesto, CA 95356-9718
Mailing address
4601 Dale Rd
Modesto, CA 95356-9718
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671667200000",
"number": "1891052189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 DALE RD",
"city": "MODESTO",
"state": "CA",
"postal_code": "953569718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4601 DALE RD",
"city": "MODESTO",
"state": "CA",
"postal_code": "953569718",
"telephone_number": "209-735-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENKATAKRISHINAN",
"first_name": "PRABHAKAR",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-12",
"last_updated": "2022-12-22",
"certification_date": "2022-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.