NPIMap

Individual provider Active NPI

Machender Reddy Kandadi, RPH., PHD

  • Pharmacist
  • Paris, TX
National Provider Identifier
1376916577
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
55398 Issued in TX
Practice address
3603 Lamar Ave
Paris, TX 75460-9400
Phone
(903) 785-5380
NPI assigned
Nov 10, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 55398 TX Primary

Addresses

Primary practice location

3603 Lamar Ave
Paris, TX 75460-9400

Mailing address

3603 Lamar Ave
Paris, TX 75460-9400
Phone (903) 785-5380

Other identifiers 1

IdentifierTypeStateIssuer
162124503MedicaidTX

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 Philosophy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
55398TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Medprime Health Services LLC Current Accepting new patients
Clarksville Pharmacy LLC Current Accepting new patients
Medlife Pharmacy Current Accepting new patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1376916577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3603 LAMAR AVE",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754609400",
            "telephone_number": "903-785-5380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3603 LAMAR AVE",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754609400",
            "telephone_number": "903-785-5380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDADI",
        "first_name": "MACHENDER",
        "middle_name": "REDDY",
        "credential": "RPH., PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-10",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "55398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162124503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paris, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.