Active NPI
Gary V Prater, PSY D
- Psychologist
- Ashland, KY
National Provider Identifier
1922011253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 0571
- Practice address
- 3701 Lansdowne Dr
Ashland, KY 41102 - Phone
- (606) 324-3005
- Fax
- (606) 329-1530
- NPI assigned
- Aug 15, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0571 | KY | Primary |
Addresses
Primary practice location
3701 Lansdowne Dr
Ashland, KY 41102
Mailing address
PO Box 790
Ashland, KY 41105-0790
Phone (606) 329-8588
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000224318 | Other | ANTHEM BCBS | |
| 0871463 | Medicaid | OH | |
| 001723355 | Other | MSBCBS | |
| 10983 | Other | CHA | |
| 7100283070 | Medicaid | KY | |
| 11726241 | Other | CAQH | |
| 227484 | Other | MANAGED HEALTH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0571 | KY | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415318400000",
"number": "1922011253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 790",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411050790",
"telephone_number": "606-329-8588",
"fax_number": "606-329-8195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 LANSDOWNE DR",
"city": "ASHLAND",
"state": "KY",
"postal_code": "41102",
"telephone_number": "606-324-3005",
"fax_number": "606-329-1530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRATER",
"first_name": "GARY",
"middle_name": "V",
"credential": "PSY D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2014-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "KY",
"license": "0571",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000224318",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0871463",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MSBCBS",
"identifier": "001723355",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHA",
"identifier": "10983",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100283070",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11726241",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH",
"identifier": "227484",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashland, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.