Active NPI
Deepa Vijaykumar Menon
- Pharmacist
- Pasadena, MD
National Provider Identifier
1831410240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18277
- Practice address
- 3400 Mountain Road
Pasadena, MD 21122 - Phone
- (410) 360-1509
- Fax
- (410) 360-4209
- NPI assigned
- Jun 21, 2010
- 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 | 18277 | MD | Primary |
Addresses
Primary practice location
3400 Mountain Road
Pasadena, MD 21122
Mailing address
3400 Mountain Road
Pasadena, MD 21122
Phone (410) 360-1509
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18277 | Other | MD | LICENSE NUMBER |
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 |
|---|---|---|---|
| 18277 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280102400000",
"number": "1831410240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 MOUNTAIN ROAD",
"city": "PASADENA",
"state": "MD",
"postal_code": "21122",
"telephone_number": "410-360-1509",
"fax_number": "410-360-4209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 MOUNTAIN ROAD",
"city": "PASADENA",
"state": "MD",
"postal_code": "21122",
"telephone_number": "410-360-1509",
"fax_number": "410-360-4209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENON",
"first_name": "DEEPA",
"middle_name": "VIJAYKUMAR",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-21",
"last_updated": "2010-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "18277",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "18277",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.