Individual provider Active NPI

Lisa Korandovich, RPH

  • Pharmacist
  • Columbus, OH
National Provider Identifier
1770879769
Registry record updated Jun 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03217858 Issued in OH
Practice address
1717 Olentangy River Rd
T1899
Columbus, OH 43212-1452
Phone
(800) 366-2690
NPI assigned
Jun 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 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 03217858 OH Primary

Addresses

Primary practice location

1717 Olentangy River Rd
T1899
Columbus, OH 43212-1452

Mailing address

1717 Olentangy River Rd
T1899
Columbus, OH 43212-1452
Phone (800) 366-2690

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
03217858OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1770879769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 OLENTANGY RIVER RD",
            "address_2": "T1899",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432121452",
            "telephone_number": "800-366-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 OLENTANGY RIVER RD",
            "address_2": "T1899",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432121452",
            "telephone_number": "800-366-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORANDOVICH",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03217858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.