Individual provider Active NPI

Prangchat Fakto

  • Assisted Living Facility
  • Jeffersonville, IN
National Provider Identifier
1902509151
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Practice address
2105 Hamburg Pike
Jeffersonville, IN 47130-6301
Phone
(812) 577-8542
NPI assigned
Mar 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary
Speech-Language Pathologist 235Z00000X 22008398A IN

Addresses

Primary practice location

2105 Hamburg Pike
Jeffersonville, IN 47130-6301

Mailing address

10 S 9TH St Ste 4
Noblesville, IN 46060-2631
Phone (317) 204-3736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230502002965 IN Practitioner - Qualified Speech Language Pathologist 4385009075 Reassigns benefits to 2 organizations
I20230505000321 KY Practitioner - Qualified Speech Language Pathologist 4385009075 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthpro Heritage Rehab and Fitness LLC 976 clinicians

Practice addresses (Care Compare)

6700 Overlook Dr
Louisville, KY 40241-6583
Phone (502) 323-3806

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Speech-Language Pathologist Current Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Jan 23, 2025 Accepting new patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince May 1, 2023 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Speech-Language Pathologist CurrentSince Apr 28, 2023 Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Jan 23, 2025 Accepting new patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince May 1, 2023 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Aug 11, 2025 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Aug 11, 2025 Accepting new patients

Locations

300 E Washington Blvd
Fort Wayne, IN 46802
Phone (260) 422-5511

7900 Rhode Island St
#1504
Merrillville, IN 46410
Phone (219) 649-0625

10 S 9th St
Ste 4
Noblesville, IN 46060

6700 Overlook Dr
Louisville, KY 40241
Phone (402) 724-9166

9107 Taylorsville Rd
Apt 137
Louisville, KY 40299
Phone (502) 380-6585

10210 Long Home Rd
Louisville, KY 40291
Phone (502) 231-4522

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1902509151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 S 9TH ST STE 4",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460602631",
            "telephone_number": "317-204-3736",
            "fax_number": "317-324-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 HAMBURG PIKE",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471306301",
            "telephone_number": "812-577-8542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKTO",
        "first_name": "PRANGCHAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22008398A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.