Active NPI
Vijaysri Nannapaneni
- Pharmacist
- Stockton, CA
National Provider Identifier
1093113631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 67504
- Practice address
- 1801 E March LN
Suite B280
Stockton, CA 95210-6629 - Phone
- (209) 474-2888
- Fax
- (209) 474-3328
- NPI assigned
- Dec 15, 2014
- Last updated
- Dec 15, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 67504 | CA | Primary |
Addresses
Primary practice location
1801 E March LN
Suite B280
Stockton, CA 95210-6629
Mailing address
1801 E March LN
Suite B280
Stockton, CA 95210-6629
Phone (209) 474-2888
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smart Pharmacy, LLC | Past | Accepting new patients | |
| Smart Pharmacy, LLC | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418601600000",
"number": "1093113631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 E MARCH LN",
"address_2": "SUITE B280",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952106629",
"telephone_number": "209-474-2888",
"fax_number": "209-474-3328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 E MARCH LN",
"address_2": "SUITE B280",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952106629",
"telephone_number": "209-474-2888",
"fax_number": "209-474-3328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NANNAPANENI",
"first_name": "VIJAYSRI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-15",
"last_updated": "2014-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "67504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.