Active NPI
Olivia Endredi, PHARMD RPH
- Pharmacist
- Mentor, OH
National Provider Identifier
1174176317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03331376
- Practice address
- 7232 Justin Way
Mentor, OH 44060-4881 - Phone
- (440) 578-8200
- NPI assigned
- Jul 17, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 03331376 | OH | Primary |
Addresses
Primary practice location
7232 Justin Way
Mentor, OH 44060-4881
Mailing address
7232 Justin Way
Mentor, OH 44060-4881
Phone (440) 578-8200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0443757 | Medicaid | OH |
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
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03331376 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marc Glassman Inc | 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": "1563321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623542400000",
"number": "1174176317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7232 JUSTIN WAY",
"city": "MENTOR",
"state": "OH",
"postal_code": "440604881",
"telephone_number": "440-578-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7232 JUSTIN WAY",
"city": "MENTOR",
"state": "OH",
"postal_code": "440604881",
"telephone_number": "440-578-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENDREDI",
"first_name": "OLIVIA",
"credential": "PHARMD RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-17",
"last_updated": "2021-06-13",
"certification_date": "2021-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03331376",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0443757",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mentor, OH
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- Courtney Marie Emerick
- Empowerme Rehabilitation Illinois, LLC
- Encompass Remote Inc
- Endoscopy Center of Lake County, LLC
- Maryanne Engel, RN
- Kelli Lynn Enzerra, LISW
- William L Eppich, DPT
- Angela Marie Eppler, MEDICAL ASSISTANT
- Erie Optical (Robert Waldman OD)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.