Individual provider Active NPI

Pramila Badhrinarayanan

  • Pharmacist
  • Saint Louis, MO
National Provider Identifier
1114201894
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0045200 Issued in MO
Practice address
630 N McKnight Rd
Saint Louis, MO 63132-4911
Phone
(314) 991-3402
Fax
(314) 991-8473
NPI assigned
Sep 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0045200 MO Primary
Pharmacist 183500000X 3059 HI

Addresses

Primary practice location

630 N McKnight Rd
Saint Louis, MO 63132-4911

Mailing address

630 N McKnight Rd
Saint Louis, MO 63132-4911
Phone (314) 991-3402

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
3059HIMDPharmacist
0045200MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients

Organizations & group practices 1

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": "1317254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1114201894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 N MCKNIGHT RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631324911",
            "telephone_number": "314-991-3402",
            "fax_number": "314-991-8473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N MCKNIGHT RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631324911",
            "telephone_number": "314-991-3402",
            "fax_number": "314-991-8473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADHRINARAYANAN",
        "first_name": "PRAMILA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-29",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "0045200",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "HI",
            "license": "3059",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; 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.