Active NPI
Bhagya Lakshmi Gummadi
- Pharmacist
- Canton, MI
National Provider Identifier
1760772107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302037825
- Practice address
- 4902 Dewit Rd
Suite # 104
Canton, MI 48188 - Phone
- (734) 398-7796
- NPI assigned
- Apr 19, 2011
- Last updated
- Apr 19, 2011
- Sex
- Female
- 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 | 5302037825 | MI | Primary |
Addresses
Primary practice location
4902 Dewit Rd
Suite # 104
Canton, MI 48188
Mailing address
3081 Kenilworth Dr
Windsor, ONTARIO N9E4M6
CA
Phone (519) 966-0419
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 |
|---|---|---|---|
| 5302037825 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Reliance Group | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303171200000",
"number": "1760772107",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "3081 KENILWORTH DR",
"city": "WINDSOR",
"state": "ONTARIO",
"postal_code": "N9E4M6",
"telephone_number": "519-966-0419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4902 DEWIT RD",
"address_2": "SUITE # 104",
"city": "CANTON",
"state": "MI",
"postal_code": "48188",
"telephone_number": "734-398-7796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUMMADI",
"first_name": "BHAGYA",
"middle_name": "LAKSHMI",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-19",
"last_updated": "2011-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302037825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.