Active NPI
Renisha Rabara
- Pharmacist
- Indian Land, SC
National Provider Identifier
1235736133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 38060
- Practice address
- 2742 Disney PL
Indian Land, SC 29707-5957 - Phone
- (980) 228-6947
- NPI assigned
- Oct 4, 2020
- 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 | 28440 | NC | |
| Pharmacist | 183500000X | 38060 | SC | Primary |
Addresses
Primary practice location
2742 Disney PL
Indian Land, SC 29707-5957
Mailing address
2742 Disney PL
Indian Land, SC 29707-5957
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 |
|---|---|---|---|
| 28440 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| 38060 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601769600000",
"number": "1235736133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2742 DISNEY PL",
"city": "INDIAN LAND",
"state": "SC",
"postal_code": "297075957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2742 DISNEY PL",
"city": "INDIAN LAND",
"state": "SC",
"postal_code": "297075957",
"telephone_number": "980-228-6947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RABARA",
"first_name": "RENISHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-04",
"last_updated": "2020-10-04",
"certification_date": "2020-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "28440",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "38060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indian Land, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.