Active NPI
Jith Ponnambalath
- Pharmacist
- Baltimore, MD
National Provider Identifier
1396396115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18229
- Practice address
- 2509 Pennsylvania Ave
Baltimore, MD 21217-1740 - Phone
- (410) 225-2901
- NPI assigned
- Sep 23, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18229 | MD | Primary |
Addresses
Primary practice location
2509 Pennsylvania Ave
Baltimore, MD 21217-1740
Mailing address
2509 Pennsylvania Ave
Baltimore, MD 21217-1740
Phone (410) 225-2901
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | pharmacy |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569196800000",
"number": "1396396115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2509 PENNSYLVANIA AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212171740",
"telephone_number": "410-225-2901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2509 PENNSYLVANIA AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212171740",
"telephone_number": "410-225-2901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONNAMBALATH",
"first_name": "JITH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-23",
"last_updated": "2019-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "18229",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "pharmacy",
"affiliation": "N",
"address_1": "2509 Pennsylvania Ave",
"city": "Baltimore",
"state": "MD",
"country_code": "US",
"postal_code": "212171740",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.