Individual provider Active NPI

Raymond G. Pratt, MD

  • Interventional Cardiology Physician
  • Dayton, OH
National Provider Identifier
1891764007
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
35047818 Issued in OH
Practice address
4160 Little York Rd
Suite 20
Dayton, OH 45414-5800
Phone
(937) 454-9527
Fax
(937) 454-9532
NPI assigned
Mar 17, 2006
Last updated
Jan 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 35-047818-P OH
Internal Medicine Physician 207R00000X 35047818 OH
Cardiovascular Disease Physician 207RC0000X 35047818 OH
Interventional Cardiology Physician 207RI0011X 35047818 OH Primary

Addresses

Primary practice location

4160 Little York Rd
Suite 20
Dayton, OH 45414-5800

Mailing address

4160 Little York Rd
Suite 20
Dayton, OH 45414-5800
Phone (937) 454-9527

Other identifiers 2

IdentifierTypeStateIssuer
0676282MedicaidOH
110077874OtherOHRAILROAD MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/
Direct Messaging Address rpratt441839@direct.ketteringhealth.org

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

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Professional Readers Group, Inc Specialist Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1891764007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 LITTLE YORK RD",
            "address_2": "SUITE 20",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454145800",
            "telephone_number": "937-454-9527",
            "fax_number": "937-454-9532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 LITTLE YORK RD",
            "address_2": "SUITE 20",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454145800",
            "telephone_number": "937-454-9527",
            "fax_number": "937-454-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "RAYMOND",
        "middle_name": "G.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35-047818-P",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35047818",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35047818",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OH",
            "license": "35047818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0676282",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110077874",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4160 Little York Rd",
            "address_2": "Suite 20",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454145800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpratt441839@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "4160 Little York Rd",
            "address_2": "Suite 20",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454145800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.