Active NPI
Dave Prakash, MD
- Clinic/Center
- Bossier City, LA
National Provider Identifier
1912201435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- 234586
- Practice address
- 5526 Lake Side Dr
Bossier City, LA 71111-5504 - Phone
- (315) 882-2278
- NPI assigned
- Dec 23, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 234586 | NY | Primary |
Addresses
Primary practice location
5526 Lake Side Dr
Bossier City, LA 71111-5504
Mailing address
PO Box 184
Barksdale Afb, LA 71110-0184
Phone (315) 882-2278
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 234586 | NY | MD | Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293062400000",
"number": "1912201435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 184",
"city": "BARKSDALE AFB",
"state": "LA",
"postal_code": "711100184",
"telephone_number": "315-882-2278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5526 LAKE SIDE DR",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711115504",
"telephone_number": "315-882-2278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRAKASH",
"first_name": "DAVE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-12-23",
"last_updated": "2010-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "NY",
"license": "234586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bossier City, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.