Individual provider Active NPI

Lavanya Audhireddy

  • Pharmacist
  • San Jose, CA
National Provider Identifier
1194383653
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
59577 Issued in CA
Practice address
4850 San Felipe Rd
San Jose, CA 95135-1266
Phone
(408) 532-2952
NPI assigned
May 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 59577 CA Primary

Addresses

Primary practice location

4850 San Felipe Rd
San Jose, CA 95135-1266

Mailing address

3558 Jasmine Cir
San Jose, CA 95135-2367
Phone (949) 981-3574

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
59577CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Longs Drug Stores California LLC Past Accepting new patients
Longs Drug Store California LLC Past 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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1194383653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3558 JASMINE CIR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951352367",
            "telephone_number": "949-981-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 SAN FELIPE RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951351266",
            "telephone_number": "408-532-2952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUDHIREDDY",
        "first_name": "LAVANYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "59577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.