Individual provider Active NPI

Mahendra Ragupathy

  • Pharmacist
  • Clawson, MI
National Provider Identifier
1336710045
Registry record updated Jul 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302036820 Issued in MI
Practice address
560 W 14 Mile Rd
Clawson, MI 48017-1930
Phone
(248) 430-8775
NPI assigned
Jul 3, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302036820 MI Primary

Addresses

Primary practice location

560 W 14 Mile Rd
Clawson, MI 48017-1930

Mailing address

1893 Shepherds Dr
Troy, MI 48084-5405
Phone (248) 854-1724

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
5302036820MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1625270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625270400000",
    "number": "1336710045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1893 SHEPHERDS DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480845405",
            "telephone_number": "248-854-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W 14 MILE RD",
            "city": "CLAWSON",
            "state": "MI",
            "postal_code": "480171930",
            "telephone_number": "248-430-8775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGUPATHY",
        "first_name": "MAHENDRA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-03",
        "last_updated": "2021-07-03",
        "certification_date": "2021-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302036820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clawson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2021; 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.