Individual provider Active NPI

Purna Prasad, PHARMD

  • Pharmacist
  • Saint Petersburg, FL
National Provider Identifier
1013517671
Registry record updated Oct 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS57848 Issued in FL
Practice address
201 34TH St N
Saint Petersburg, FL 33713-8552
Phone
(727) 803-9607
Fax
(727) 803-4962
NPI assigned
Oct 31, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS57848 FL Primary

Addresses

Primary practice location

201 34TH St N
Saint Petersburg, FL 33713-8552

Mailing address

2619 W Saint Conrad St
Tampa, FL 33607-2918
Phone (772) 240-4611

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
PS57848FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East LP PastSince Nov 8, 2020 Accepting new patients
Wal-Mart Stores East, LP PastSince Nov 8, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1604102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604102400000",
    "number": "1013517671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 W SAINT CONRAD ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336072918",
            "telephone_number": "772-240-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 34TH ST N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337138552",
            "telephone_number": "727-803-9607",
            "fax_number": "727-803-4962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRASAD",
        "first_name": "PURNA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-31",
        "last_updated": "2020-10-31",
        "certification_date": "2020-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS57848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.