Active NPI
Mahitha Vasireddy
- Pharmacist
- Champaign, IL
National Provider Identifier
1609145861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051295383
- Practice address
- 1509 S Neil St
Champaign, IL 61820-6531 - Phone
- (217) 351-1516
- NPI assigned
- Dec 16, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 051295383 | IL | Primary |
Addresses
Primary practice location
1509 S Neil St
Champaign, IL 61820-6531
Mailing address
2520 Fields South Dr
Apt 207
Champaign, IL 61822-3708
Phone (708) 955-5756
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
| License | State | Type | Specialty |
|---|---|---|---|
| 051295383 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324425600000",
"number": "1609145861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2520 FIELDS SOUTH DR",
"address_2": "APT 207",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618223708",
"telephone_number": "708-955-5756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1509 S NEIL ST",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618206531",
"telephone_number": "217-351-1516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASIREDDY",
"first_name": "MAHITHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-16",
"last_updated": "2011-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051295383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.