Active NPI
Prasad R Medavarapu
- Pharmacist
- Lumberton, NJ
National Provider Identifier
1619134103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RJ03194
- Practice address
- 1613 Route 38
Lumberton, NJ 08048-2921 - Phone
- (609) 914-4890
- NPI assigned
- May 21, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPI000736 | PA | |
| Pharmacist | 183500000X | 28RJ03194 | NJ | Primary |
Addresses
Primary practice location
1613 Route 38
Lumberton, NJ 08048-2921
Mailing address
1613 Route 38
Lumberton, NJ 08048-2921
Phone (609) 914-4890
Other practice location 1
1601 Kings Hwy N Ste 400
Cherry Hill, NJ 08034-2309
Phone (856) 428-5888
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 |
|---|---|---|---|
| 28RJ03194 | NJ | MD | Pharmacist |
| RPI000736 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medscare LLC | Pharmacist | Current | Accepting new patients |
| Medscare LLC | Current | Accepting new patients |
Locations
1601 Kings Hwy N
Ste 400
Cherry Hill, NJ 08034
Phone (856) 428-5888
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": "1211328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696896000000",
"number": "1619134103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1613 ROUTE 38",
"city": "LUMBERTON",
"state": "NJ",
"postal_code": "080482921",
"telephone_number": "609-914-4890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1613 ROUTE 38",
"city": "LUMBERTON",
"state": "NJ",
"postal_code": "080482921",
"telephone_number": "609-914-4890"
}
],
"practiceLocations": [
{
"address_1": "1601 Kings Hwy N Ste 400",
"address_purpose": "LOCATION",
"city": "Cherry Hill",
"state": "NJ",
"postal_code": "080342309",
"country_code": "US",
"telephone_number": "856-428-5888",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEDAVARAPU",
"first_name": "PRASAD",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-21",
"last_updated": "2023-10-10",
"certification_date": "2023-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RPI000736",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RJ03194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lumberton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.