Active NPI
Raghavendra Nagarur
- Pharmacist
- Mesa, AZ
National Provider Identifier
1891101234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S015001
- Practice address
- 1955 S Stapley Dr
Mesa, AZ 85204-6615 - Phone
- (480) 892-0306
- Fax
- (480) 892-8214
- NPI assigned
- Jul 7, 2014
- Last updated
- Jul 7, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | S015001 | AZ | Primary |
Addresses
Primary practice location
1955 S Stapley Dr
Mesa, AZ 85204-6615
Mailing address
855 N Dobson Rd
Apt 2092
Chandler, AZ 85224-6902
Phone (480) 528-5661
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 |
|---|---|---|---|
| S015001 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404691200000",
"number": "1891101234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 N DOBSON RD",
"address_2": "APT 2092",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852246902",
"telephone_number": "480-528-5661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1955 S STAPLEY DR",
"city": "MESA",
"state": "AZ",
"postal_code": "852046615",
"telephone_number": "480-892-0306",
"fax_number": "480-892-8214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAGARUR",
"first_name": "RAGHAVENDRA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-07",
"last_updated": "2014-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S015001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.