Active NPI
Prasad Shiva Ramesh, PHARMACIST
- Pharmacist
- San Antonio, TX
National Provider Identifier
1710580055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 52211
- Practice address
- 4096 N Foster Rd
San Antonio, TX 78244-1874 - Phone
- (210) 507-4962
- Fax
- (210) 507-4963
- NPI assigned
- Nov 19, 2020
- 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 | 52211 | TX | Primary |
Addresses
Primary practice location
4096 N Foster Rd
San Antonio, TX 78244-1874
Mailing address
Walmart Pharmacy
4096 North Foster Road
San Antonio, TX 78244
Phone (210) 507-4962
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52211 | Other | TX | RPH LICENSE NUMBER |
| 1447590625 | Medicaid | TX |
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 |
|---|---|---|---|
| 52211 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605744000000",
"number": "1710580055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "WALMART PHARMACY",
"address_2": "4096 NORTH FOSTER ROAD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78244",
"telephone_number": "210-507-4962",
"fax_number": "210-507-4963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4096 N FOSTER RD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782441874",
"telephone_number": "210-507-4962",
"fax_number": "210-507-4963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAMESH",
"first_name": "PRASAD",
"middle_name": "SHIVA",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-19",
"last_updated": "2020-11-19",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "52211",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RPH LICENSE NUMBER",
"identifier": "52211",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1447590625",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.