Active NPI
Samundra Bhattarai
- Pharmacist
- Kayenta, AZ
National Provider Identifier
1104498732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PHCY-01155
- Practice address
- 394.3 US-160
Kayenta, AZ 86033 - Phone
- (928) 697-4000
- NPI assigned
- Jul 13, 2021
- Sex
- Male
- Sole proprietor
- Yes
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
| License | State | Type | Specialty |
|---|---|---|---|
| PHCY-01155 | NH | MD | Pharmacist |
| 033.0134475 | VT | MD | Pharmacist |
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 033.0134475 | VT | |
| Pharmacist | 183500000X | PHCY-01155 | NH | Primary |
Addresses
Primary practice location
394.3 US-160
Kayenta, AZ 86033
Mailing address
PO Box 2384
Kayenta, AZ 86033-2384
Phone (280) 602-9226
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHCY-01155 | Other | NH | PHARMACY LICENSE |
| 033.0134475 | Other | VT | LICENSE |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://securedata.ihs.gov/bds/Login.do | ||
| Other URL | https://securedata.ihs.gov/bds/Login.do |
NPI Registry JSON
{
"created_epoch": "1626134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626134400000",
"number": "1104498732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2384",
"city": "KAYENTA",
"state": "AZ",
"postal_code": "860332384",
"telephone_number": "280-602-9226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "394.3 US-160",
"city": "KAYENTA",
"state": "AZ",
"postal_code": "86033",
"telephone_number": "928-697-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BHATTARAI",
"first_name": "SAMUNDRA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-07-13",
"last_updated": "2021-07-13",
"certification_date": "2021-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VT",
"license": "033.0134475",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NH",
"license": "PHCY-01155",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE",
"identifier": "PHCY-01155",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "033.0134475",
"state": "VT"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://securedata.ihs.gov/bds/Login.do",
"affiliation": "N",
"address_1": "394.3 US-160",
"city": "KAYENTA",
"state": "AZ",
"country_code": "US",
"postal_code": "86033",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://securedata.ihs.gov/bds/Login.do",
"affiliation": "N",
"address_1": "394.3 US-160",
"city": "KAYENTA",
"state": "AZ",
"country_code": "US",
"postal_code": "86033",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Kayenta, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.