Individual provider Active NPI

Manju Rani Katiyar-Mitchell, RPH

  • Pharmacist
  • Lake Charles, LA
National Provider Identifier
1437464641
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16236 Issued in LA
Practice address
2000 Gertsner Memorial Dr
Lake Charles, LA 70601-8060
Phone
(337) 439-7114
Fax
(337) 433-4586
NPI assigned
Aug 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16236 LA Primary

Addresses

Primary practice location

2000 Gertsner Memorial Dr
Lake Charles, LA 70601-8060

Mailing address

2000 Gertsner Memorial Dr
Lake Charles, LA 70601-8060
Phone (337) 439-7114

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
16236LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1437464641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GERTSNER MEMORIAL DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018060",
            "telephone_number": "337-439-7114",
            "fax_number": "337-433-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 GERTSNER MEMORIAL DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018060",
            "telephone_number": "337-439-7114",
            "fax_number": "337-433-4586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATIYAR-MITCHELL",
        "first_name": "MANJU",
        "middle_name": "RANI",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "16236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.