Active NPI
Ravi Kumar Chenna, R.PH
- Pharmacist
- Elizabeth, NJ
National Provider Identifier
1104097203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI03056500
- Practice address
- 1000 S Elmora Ave
Elizabeth, NJ 07202-3100 - Phone
- (908) 629-1265
- NPI assigned
- Mar 17, 2008
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3338 | NH | |
| Pharmacist | 183500000X | 000167 | NY | |
| Pharmacist | 183500000X | 28RI03056500 | NJ | Primary |
Addresses
Primary practice location
1000 S Elmora Ave
Elizabeth, NJ 07202-3100
Mailing address
1000 S Elmora Ave
Elizabeth, NJ 07202-3100
Phone (908) 629-1265
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000167 | NY | MD | Marriage & Family Therapist |
| 3338 | NH | MD | Dentist |
| 28RI03056500 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205712000000",
"number": "1104097203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 S ELMORA AVE",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "072023100",
"telephone_number": "908-629-1265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 S ELMORA AVE",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "072023100",
"telephone_number": "908-629-1265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHENNA",
"first_name": "RAVI",
"middle_name": "KUMAR",
"name_prefix": "Mr.",
"credential": "R.PH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-17",
"last_updated": "2008-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NH",
"license": "3338",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "000167",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03056500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabeth, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.