Individual provider Active NPI

Srivani Pentela

  • Pharmacist
  • Roanoke, VA
National Provider Identifier
1356609200
Registry record updated Apr 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202211110 Issued in VA
Practice address
3631 Peters Creek Rd NW
Roanoke, VA 24019-2809
Phone
(732) 421-6677
NPI assigned
Apr 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202211110 VA Primary

Addresses

Primary practice location

3631 Peters Creek Rd NW
Roanoke, VA 24019-2809

Mailing address

20816 Wallingford SQ
Sterling, VA 20165-7387

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
0202211110VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1335657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335657600000",
    "number": "1356609200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20816 WALLINGFORD SQ",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201657387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3631 PETERS CREEK RD NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240192809",
            "telephone_number": "732-421-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTELA",
        "first_name": "SRIVANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-29",
        "last_updated": "2012-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202211110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2012; 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.