Individual provider Active NPI

Ida J Kuruvilla, BS

  • Pharmacist
  • Glen Burnie, MD
National Provider Identifier
1912213950
Registry record updated Aug 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11127 Issued in MD
Practice address
7501 Ritchie Hwy
Glen Burnie, MD 21061-3716
Phone
(410) 766-5220
Fax
(410) 760-3634
NPI assigned
Aug 27, 2010
Last updated
Aug 27, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11127 MD Primary

Addresses

Primary practice location

7501 Ritchie Hwy
Glen Burnie, MD 21061-3716

Mailing address

7501 Ritchie Hwy
Glen Burnie, MD 21061-3716
Phone (410) 766-5220

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
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
11127MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282867200000",
    "number": "1912213950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 RITCHIE HWY",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613716",
            "telephone_number": "410-766-5220",
            "fax_number": "410-760-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 RITCHIE HWY",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613716",
            "telephone_number": "410-766-5220",
            "fax_number": "410-760-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURUVILLA",
        "first_name": "IDA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-27",
        "last_updated": "2010-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "11127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.

Verify at the official NPI Registry.