Individual provider Active NPI

Adinarayana Andy

  • Pharmacist
  • Jackson, MI
National Provider Identifier
1437514957
Registry record updated Dec 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302042414 Issued in MI
Practice address
210 Hinckley Blvd
Jackson, MI 49203-5313
Phone
(517) 784-3184
Fax
(517) 784-2202
NPI assigned
Dec 28, 2015
Last updated
Dec 28, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 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 5302042414 MI Primary

Addresses

Primary practice location

210 Hinckley Blvd
Jackson, MI 49203-5313

Mailing address

210 Hinckley Blvd
Jackson, MI 49203-5313
Phone (517) 784-3184

Other identifiers 1

IdentifierTypeStateIssuer
5302042414OtherMIPHARMACIST LICENSE NUMBER

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
5302042414MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Weatherwax Family Pharmacies Inc Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1451260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451260800000",
    "number": "1437514957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 HINCKLEY BLVD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492035313",
            "telephone_number": "517-784-3184",
            "fax_number": "517-784-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 HINCKLEY BLVD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492035313",
            "telephone_number": "517-784-3184",
            "fax_number": "517-784-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDY",
        "first_name": "ADINARAYANA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-28",
        "last_updated": "2015-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302042414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE NUMBER",
            "identifier": "5302042414",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.