Individual provider Active NPI

Guru Boggarapu, R.PH

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1770905119
Registry record updated Jan 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S014629 Issued in AZ
Practice address
2435 E Baseline Rd
Phoenix, AZ 85042-7004
Phone
(602) 232-2982
NPI assigned
Jan 18, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S014629 AZ Primary

Addresses

Primary practice location

2435 E Baseline Rd
Phoenix, AZ 85042-7004

Mailing address

15801 S 48TH St
Apt 1017
Phoenix, AZ 85048-0807
Phone (480) 235-8219

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
S014629AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walmart Inc. Past Accepting new patients
Walmart Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1390003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390003200000",
    "number": "1770905119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15801 S 48TH ST",
            "address_2": "APT 1017",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480807",
            "telephone_number": "480-235-8219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 E BASELINE RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850427004",
            "telephone_number": "602-232-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGARAPU",
        "first_name": "GURU",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-18",
        "last_updated": "2014-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S014629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2014; 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.