DR. PRASANTH M PRASANNA (NPI# 1972678845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972678845 |
| Entity Type | Individual |
| Full Name | DR. PRASANTH M PRASANNA |
| Credential | MD |
| Practice Address |
698 12th St Se Ste 145 Salem OR 97301 |
| Mailing Address |
698 12th St Se Ste 145 Salem OR 97301-4076 |
| Practice Telephone | 5035861315 |
| Mailing Telephone | 5035861315 |
| Enumeration Date | 2006-11-23 |
| Last Update Date | 2018-05-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD156365 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500641671 | 05 |
| Street Address |
698 12TH ST SE STE 145 |
| City | SALEM |
| State | OR |
| Zip Code | 97301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093779282 | Edwin Yen Wang | Radiology | 698 12th St Se Ste 145, Salem, OR 97301 | 2006-04-14 |
| 1669518049 | Christopher Dillon Goeser | Radiology | 698 12th St Se Ste 145, Salem, OR 97301-4076 | 2007-01-30 |
| 1356408215 | Diagnostic Imaging Associates Inc | Radiology | 698 12th St Se Ste 145, Salem, OR 97301 | 2007-01-02 |
| 1154488021 | Victor Joseph Leonardo | Radiology | 698 12th St Se Ste 145, Salem, OR 97301 | 2007-01-02 |
| 1821155797 | Robert Wayne Myers | Radiology | 698 12th St Se Ste 145, Salem, OR 97301 | 2007-01-02 |
| 1407913379 | Joseph Douglas Trudeau | Radiology | 698 12th St Se Ste 145, Salem, OR 97301 | 2007-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730357617 | Ralph E Adams | Radiology | 3506 Cherokee Dr S, Salem, OR 97302-9712 | 2008-02-13 |
| 1760565303 | Piper Rooke | Radiology | 1165 Union St Ne Ste 100, Salem, OR 97301-4693 | 2006-10-24 |
| 1679586234 | Stephen E Fitch | Radiology | Skyline Medical Office, 5125 Skyline Rd, S, Kaiser Permanente, Salem, OR 97306-9427 | 2006-08-14 |
| 1053330639 | Robert S Andrews | Radiology | 11 Coxswain Pl, Salem, SC 29676-4442 | 2006-07-18 |
| 1093731440 | Kenneth H Elson | Radiology | 755 Honeysuckle Rd, Salem, VA 24153-2745 | 2006-07-15 |
| 1306893979 | Mission Medical Imaging | Radiology | 1155 Mission St Se, Suite 105, Salem, OR 97302-6228 | 2006-05-28 |
| 1417908757 | Jose Novoa | Radiology | 2925 Ryan Dr Se, Salem, OR 97301-9687 | 2006-05-12 |
| 1093779282 | Edwin Yen Wang | Radiology | 698 12th St Se Ste 145, Salem, OR 97301 | 2006-04-14 |
| 1548247901 | Placido De Guzman | Radiology | 1970 Roanoke Blvd., Salem, VA 24153-6404 | 2005-12-28 |
| 1215924089 | Salem Radiology Associates | Radiology | 310 Woodstown Rd, Salem, NJ 08079-2064 | 2005-10-05 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.