Active NPI
Kaushik V K Vedam, PHARMD
- Pharmacist
- Dallas, TX
National Provider Identifier
1558945287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 52604
- Practice address
- 6300 Samuell Blvd
Dallas, TX 75228-7137 - Phone
- (972) 412-7373
- Fax
- (972) 412-8484
- NPI assigned
- May 10, 2021
- 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 | 52604 | TX | Primary |
Addresses
Primary practice location
6300 Samuell Blvd
Dallas, TX 75228-7137
Mailing address
9543 Bramble Mead LN
Frisco, TX 75035-1290
Phone (630) 405-9538
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | safemed | Direct |
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52604 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| R2J Investments LLC | Current | 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": "1620604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620604800000",
"number": "1558945287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9543 BRAMBLE MEAD LN",
"city": "FRISCO",
"state": "TX",
"postal_code": "750351290",
"telephone_number": "630-405-9538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6300 SAMUELL BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752287137",
"telephone_number": "972-412-7373",
"fax_number": "972-412-8484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEDAM",
"first_name": "KAUSHIK",
"middle_name": "V K",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-10",
"last_updated": "2021-05-10",
"certification_date": "2021-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "52604",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "safemed",
"affiliation": "N",
"endpointDescription": "pharmacy",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "pharmacy",
"address_1": "6300 Samuell Blvd",
"city": "Dallas",
"state": "TX",
"country_code": "US",
"postal_code": "752287137",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.