Active NPI
Srikanth Ponnada
- Pharmacist
- Carlsbad, NM
National Provider Identifier
1144645821
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 7444
- Practice address
- 808 N Canal St
Carlsbad, NM 88220-2418 - Phone
- (575) 887-5085
- NPI assigned
- Mar 4, 2014
- Last updated
- Mar 4, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 7444 | NM | Primary |
Addresses
Primary practice location
808 N Canal St
Carlsbad, NM 88220-2418
Mailing address
1933 Leanne Dr
Carlsbad, NM 88220-4490
Phone (541) 314-3271
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61512 | Medicaid | NM |
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 |
|---|---|---|---|
| 7444 | NM | MD | Pharmacist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pharmacy
- Carlsbad, NM
- NPI 1962711770
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393891200000",
"number": "1144645821",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1933 LEANNE DR",
"city": "CARLSBAD",
"state": "NM",
"postal_code": "882204490",
"telephone_number": "541-314-3271",
"fax_number": "575-887-8300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "808 N CANAL ST",
"city": "CARLSBAD",
"state": "NM",
"postal_code": "882202418",
"telephone_number": "575-887-5085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONNADA",
"first_name": "SRIKANTH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-04",
"last_updated": "2014-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "7444",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "61512",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carlsbad, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.