Active NPI
Ravi Prakash, MD., FAAP DABP MRCP
- Pediatrics Physician
- Norwich, CT
National Provider Identifier
1982698445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 035836
- Practice address
- 80 Sherman St
Norwich, CT 06360-4106 - Phone
- (860) 886-0202
- Fax
- (860) 886-5068
- NPI assigned
- Sep 9, 2005
- Reactivated
- Apr 3, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 035836 | CT | Primary |
Addresses
Primary practice location
80 Sherman St
Norwich, CT 06360-4106
Mailing address
80 Sherman St
Norwich, CT 06360-4106
Phone (860) 886-0202
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2453549 | Other | CT | AETNA |
| 001358367 | Medicaid | CT | |
| 00135836703 | Other | CT | BLUECARE FAMILY PLAN |
| 0V8084 | Other | CT | HEALTHNET |
| 1241197 | Other | CT | UNITED HEALTHCARE |
| 4682678002 | Other | CT | CIGNA |
| P2061637 | Other | CT | OXFORD |
| 010035836CT02 | Other | CT | ANTHEM BLUE CROSS |
| 744319 | Other | CT | CONNECTICARE |
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 |
|---|---|---|---|
| 035836 | CT | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224633600000",
"number": "1982698445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 SHERMAN ST",
"city": "NORWICH",
"state": "CT",
"postal_code": "063604106",
"telephone_number": "860-886-0202",
"fax_number": "860-886-5068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 SHERMAN ST",
"city": "NORWICH",
"state": "CT",
"postal_code": "063604106",
"telephone_number": "860-886-0202",
"fax_number": "860-886-5068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRAKASH",
"first_name": "RAVI",
"name_prefix": "Dr.",
"credential": "MD., FAAP DABP MRCP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-09",
"last_updated": "2008-10-22",
"deactivation_date": "2006-03-25",
"reactivation_date": "2006-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CT",
"license": "035836",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2453549",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001358367",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECARE FAMILY PLAN",
"identifier": "00135836703",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "0V8084",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1241197",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "4682678002",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P2061637",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "010035836CT02",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "744319",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.