Individual provider Active NPI

Sagar Malli, PHARMD

  • Pharmacist
  • Springfield, IL
National Provider Identifier
1689967101
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.294203 Issued in IL
Practice address
200 N Grand Ave W
Springfield, IL 62702-2551
Phone
(217) 523-7002
Fax
(217) 523-7127
NPI assigned
May 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.294203 IL Primary

Addresses

Primary practice location

200 N Grand Ave W
Springfield, IL 62702-2551

Mailing address

200 N Grand Ave W
Springfield, IL 62702-2551
Phone (217) 523-7002

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

LicenseStateTypeSpecialty
051.294203ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305590400000",
    "number": "1689967101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N GRAND AVE W",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627022551",
            "telephone_number": "217-523-7002",
            "fax_number": "217-523-7127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N GRAND AVE W",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627022551",
            "telephone_number": "217-523-7002",
            "fax_number": "217-523-7127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLI",
        "first_name": "SAGAR",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-17",
        "last_updated": "2011-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.294203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.

Verify at the official NPI Registry.