Individual provider Active NPI

Prathyusha Kunamneni, PHARM. D

  • Pharmacist
  • Frisco, TX
National Provider Identifier
1306304779
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
65589 Issued in TX
Practice address
5350 Independence Pkwy # 110a
Frisco, TX 75035-4652
Phone
(469) 885-9100
NPI assigned
Mar 5, 2019
Last updated
Jan 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI04004600 NJ
Pharmacist 183500000X 65589 TX Primary

Addresses

Primary practice location

5350 Independence Pkwy # 110a
Frisco, TX 75035-4652

Mailing address

12883 Risen Star Rd
Frisco, TX 75035-1539
Phone (248) 633-6322

Other practice location 1

2409 Alco Ave Ste C
Dallas, TX 75211-2614
Phone (214) 919-2399

Other practice location 2

507 Central Ave
Newark, NJ 07107-1466
Phone (973) 482-9300

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

State licenses

LicenseStateTypeSpecialty
28RI04004600NJMDPharmacist
65589TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Paris LLC CurrentSince Mar 1, 2022 Accepting new patients
Elevatecare Frisco LLC PastSince Jan 22, 2023 Accepting new patients

Locations

2409 Alco Ave
Ste C
Dallas, TX 75211
Phone (214) 919-2399

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1306304779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12883 RISEN STAR RD",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750351539",
            "telephone_number": "248-633-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 INDEPENDENCE PKWY # 110A",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750354652",
            "telephone_number": "469-885-9100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2409 Alco Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752112614",
            "country_code": "US",
            "telephone_number": "214-919-2399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "507 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071071466",
            "country_code": "US",
            "telephone_number": "973-482-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUNAMNENI",
        "first_name": "PRATHYUSHA",
        "name_prefix": "Dr.",
        "credential": "PHARM. D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04004600",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "65589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.