Prajakta Dravid

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

23138 Issued in MD

Practice address

407 George Clauss Blvd
Severn, MD 21144-1317

Phone

(410) 582-9335

NPI assigned

Nov 5, 2020

Last updated

Nov 5, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1285235226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 GEORGE CLAUSS BLVD",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211441317",
            "telephone_number": "410-582-9335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 GEORGE CLAUSS BLVD",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211441317",
            "telephone_number": "410-582-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAVID",
        "first_name": "PRAJAKTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "MD",
            "license": "23138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "23138",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Walmart1875",
            "affiliation": "N",
            "endpointDescription": "Walamrt 1875 Pharmacy",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Walmart 1875",
            "address_1": "407 George Clauss Blvd",
            "city": "Severn",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211441317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kassandra A Dickens, CRNP
• Oluchi Dike, M.D.
• Divine Healthcare
• Divine Healthcare
• Divine Solutions
• Shannon Leigh Drechsler
• Emade Ebah Edongole
• Beverly Ebanks
• Ecu (KSD)
• Tishay Eldridge

• Ambulatory Care Pharmacist in Severn, MD
• Providers in Severn, MD by specialty
• Ambulatory Care Pharmacist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.

Verify at the official NPI Registry.