Individual provider Active NPI

Annadurai Kuppusamy, M S (PHARM) RPH

  • Pharmacist
  • Indianapolis, IN
National Provider Identifier
1497024244
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26024369A Issued in IN
Practice address
7345 Woodland Dr
Indianapolis, IN 46278-1737
Phone
(317) 293-1700
Fax
(317) 981-6716
NPI assigned
Dec 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 64348 TX
Pharmacist 183500000X PIC021426 LA
Pharmacist 183500000X 2217477 VA
Pharmacist 183500000X PS51347 FL
Pharmacist 183500000X 26024369A IN Primary
Pharmacist 183500000X 51299282 IL
Pharmacist 183500000X 0017315 OR
Pharmacist 183500000X 5302046486 MI
Pharmacist 183500000X 0011575 WV
Pharmacist 183500000X 22328 AL

Addresses

Primary practice location

7345 Woodland Dr
Indianapolis, IN 46278-1737

Mailing address

7345 Woodland Dr
Indianapolis, IN 46278-1737
Phone (317) 293-1700

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)
Enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
64348TXMDClinical Social Worker
22328ALMDPharmacist
PS51347FLMDPharmacist
51299282ILMDPharmacist
PIC021426LAMDPharmacist
5302046486MIMDPharmacist
0017315ORMDPharmacist
2217477VAMDPharmacist
0011575WVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Milee Inc. Past Accepting new patients
Ivisit Doc Inc PastSince May 28, 2023 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": "1324598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1497024244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7345 WOODLAND DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462781737",
            "telephone_number": "317-293-1700",
            "fax_number": "317-981-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7345 WOODLAND DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462781737",
            "telephone_number": "317-293-1700",
            "fax_number": "317-981-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPPUSAMY",
        "first_name": "ANNADURAI",
        "credential": "M S (PHARM) RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-23",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "64348",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PIC021426",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "2217477",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS51347",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26024369A",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "51299282",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "0017315",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302046486",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "0011575",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "22328",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.