Active NPI
Shyam Vedi Sharma
- Pharmacist
- Modesto, CA
National Provider Identifier
1508425927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 77594
- Practice address
- 2225 Plaza Pkwy
Modesto, CA 95350-6215 - Phone
- (209) 524-4724
- NPI assigned
- Jun 10, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 77594 | CA | Primary |
Addresses
Primary practice location
2225 Plaza Pkwy
Modesto, CA 95350-6215
Mailing address
1565 Lyman PL
Ripon, CA 95366-9475
Phone (209) 918-8446
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | s0s02xu.s01587@walmart.com |
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": "1560124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560124800000",
"number": "1508425927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1565 LYMAN PL",
"city": "RIPON",
"state": "CA",
"postal_code": "953669475",
"telephone_number": "209-918-8446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 PLAZA PKWY",
"city": "MODESTO",
"state": "CA",
"postal_code": "953506215",
"telephone_number": "209-524-4724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHARMA",
"first_name": "SHYAM",
"middle_name": "VEDI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-10",
"last_updated": "2019-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "77594",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "s0s02xu.s01587@walmart.com",
"affiliation": "N",
"address_1": "2225 Plaza Pkwy",
"city": "Modesto",
"state": "CA",
"country_code": "US",
"postal_code": "953506215",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.