Individual provider Active NPI

Seetha Thummuru

  • Pharmacist
  • Leesburg, FL
National Provider Identifier
1104293695
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS52398 Issued in FL
Practice address
2501 Citrus Blvd
Leesburg, FL 34748-7204
Phone
(352) 326-4044
Fax
(352) 326-2860
NPI assigned
Aug 31, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS52398 FL Primary

Addresses

Primary practice location

2501 Citrus Blvd
Leesburg, FL 34748-7204

Mailing address

2501 Citrus Blvd
Leesburg, FL 34748-7204
Phone (352) 326-4044

Other identifiers 1

IdentifierTypeStateIssuer
PS52398OtherFLSTATE LICENSE

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

State licenses

LicenseStateTypeSpecialty
PS52398FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1104293695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CITRUS BLVD",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487204",
            "telephone_number": "352-326-4044",
            "fax_number": "352-326-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CITRUS BLVD",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487204",
            "telephone_number": "352-326-4044",
            "fax_number": "352-326-2860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUMMURU",
        "first_name": "SEETHA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS52398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PS52398",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.