Individual provider Active NPI

Shyam Vedi Sharma

  • Pharmacist
  • Modesto, CA
National Provider Identifier
1508425927
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
77594 Issued in CA
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

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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.

Verify at the official NPI Registry.