Shree Kesrinandan LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE010406 Issued in GA

Legal business name

SHREE KESRINANDAN LLC

Practice address

1086 Baxter St
Athens, GA 30606-6316

Phone

(706) 850-5553

Fax

(706) 850-7557

NPI assigned

Aug 18, 2017

Organization subpart

No

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

Authorized official

Name

Ketan TrivediNPI 1164947123

Title

Member

Phone

(678) 205-7038

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• ATHENS PHARMACY Other name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Tax ID family

Shree Kesrinandan LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Shree Kesrinandan LLC

  • Long-Term Care Clinical Nurse Specialist
  • Athens, GA
  • NPI 1407707920
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Shree Kesrinandan LLC

  • Long-Term Care Clinical Nurse Specialist
  • Athens, GA
  • NPI 1407707920
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ketan Trivedi

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Athens, GA
  • NPI 1164947123
  NPD Authorized official

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524009600000",
    "number": "1205352473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 BAXTER ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066316",
            "telephone_number": "706-850-5553",
            "fax_number": "706-850-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 BAXTER ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066316",
            "telephone_number": "706-850-5553",
            "fax_number": "706-850-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHREE KESRINANDAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-18",
        "last_updated": "2018-04-18",
        "status": "A",
        "authorized_official_last_name": "TRIVEDI",
        "authorized_official_first_name": "KETAN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "678-205-7038"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010406",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2171044",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003198628A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "athens pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ATHENS PHARMACY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carly Kohler Shockley, LCSW
• Sholes Center for Women's Health
• Emily A Sholes, M.D.
• Thomas Taylor Sholes, M.D.
• Adrienne Shook
• Shree Kesrinandan LLC
• Shivanee Shrestha, M.D.
• Tedra Dorothy Lucille Shriner, ED.S, LPC
• Sara J Shue, MS, OTR/L
• Shujuan Holdings LLC

• Community/Retail Pharmacy in Athens, GA
• Providers in Athens, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.