Individual provider Active NPI

Amita Yeshwant Shenoy

  • Pharmacist
  • Deland, FL
National Provider Identifier
1487934964
Registry record updated Aug 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS39760 Issued in FL
Practice address
2400 S Woodland Blvd
Deland, FL 32720-8636
Phone
(386) 822-4503
NPI assigned
Aug 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS39760 FL Primary

Addresses

Primary practice location

2400 S Woodland Blvd
Deland, FL 32720-8636

Mailing address

2400 S Woodland Blvd
Deland, FL 32720-8636
Phone (386) 822-4503

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
PS39760FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1314489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314489600000",
    "number": "1487934964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S WOODLAND BLVD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327208636",
            "telephone_number": "386-822-4503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S WOODLAND BLVD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327208636",
            "telephone_number": "386-822-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENOY",
        "first_name": "AMITA",
        "middle_name": "YESHWANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-28",
        "last_updated": "2011-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS39760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2011; 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.