Individual provider Active NPI

Priyamvada Gorijavolu

  • Pharmacist
  • Colorado Springs, CO
National Provider Identifier
1679873384
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18315 Issued in CO
Practice address
1425 S Murray Blvd
Colorado Springs, CO 80916-3975
Phone
(719) 591-0831
Fax
(719) 591-0847
NPI assigned
Oct 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18315 CO Primary

Addresses

Primary practice location

1425 S Murray Blvd
Colorado Springs, CO 80916-3975

Mailing address

1425 S Murray Blvd
Colorado Springs, CO 80916-3975
Phone (719) 591-0831

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

LicenseStateTypeSpecialty
18315COMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288137600000",
    "number": "1679873384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 S MURRAY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809163975",
            "telephone_number": "719-591-0831",
            "fax_number": "719-591-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 S MURRAY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809163975",
            "telephone_number": "719-591-0831",
            "fax_number": "719-591-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORIJAVOLU",
        "first_name": "PRIYAMVADA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-27",
        "last_updated": "2010-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "18315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; 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.