Active NPI
Sridevi Bavirisetty
- Pharmacist
- Breinigsville, PA
National Provider Identifier
1114476819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 450153
- Practice address
- 1063 Mosser Rd
Apt F204
Breinigsville, PA 18031 - Phone
- (609) 915-4999
- NPI assigned
- Sep 23, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302041050 | MI | |
| Pharmacist | 183500000X | 450153 | PA | Primary |
Addresses
Primary practice location
1063 Mosser Rd
Apt F204
Breinigsville, PA 18031
Mailing address
1063 Mosser Rd
Apt F204
Breinigsville, PA 18031
Phone (609) 915-4999
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 |
|---|---|---|---|
| 5302041050 | MI | MD | Pharmacist |
| 450153 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bethlehem Pharmacy RX Inc | Current | Accepting new patients | |
| Bethlehem Pharmacy RX Inc | Current | 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 and National Provider Directory roles.
-
- Long Term Care Pharmacy
- Bethlehem, PA
- NPI 1770397432
-
- Community/Retail Pharmacy
- Bethlehem, PA
- NPI 1184138489
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475798400000",
"number": "1114476819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1063 MOSSER RD",
"address_2": "APT F204",
"city": "BREINIGSVILLE",
"state": "PA",
"postal_code": "18031",
"telephone_number": "609-915-4999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1063 MOSSER RD",
"address_2": "APT F204",
"city": "BREINIGSVILLE",
"state": "PA",
"postal_code": "18031",
"telephone_number": "609-915-4999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAVIRISETTY",
"first_name": "SRIDEVI",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-23",
"last_updated": "2016-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302041050",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "450153",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Breinigsville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.