Individual provider Active NPI

Shimi Gopalakrishnan, PHARMD.

  • Pharmacist
  • Elmont, NY
National Provider Identifier
1730404401
Registry record updated Apr 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20 054309 Issued in NY
Practice address
812 Lawrence St
Elmont, NY 11003-4620
Phone
(516) 633-9877
NPI assigned
Apr 6, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 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 20 054309 NY Primary

Addresses

Primary practice location

812 Lawrence St
Elmont, NY 11003-4620

Mailing address

812 Lawrence St
Elmont, NY 11003-4620
Phone (516) 633-9877

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
20 054309NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270512000000",
    "number": "1730404401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 LAWRENCE ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034620",
            "telephone_number": "516-633-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 LAWRENCE ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034620",
            "telephone_number": "516-633-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOPALAKRISHNAN",
        "first_name": "SHIMI",
        "credential": "PHARMD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-06",
        "last_updated": "2010-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "20 054309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.