Individual provider Active NPI

Swetha Reddy Mandadi, RPH

  • Pharmacist
  • Marietta, GA
National Provider Identifier
1992017651
Registry record updated Jul 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH025170 Issued in GA
Practice address
4250 Roswell Rd
Marietta, GA 30062-6498
Phone
(770) 565-4064
NPI assigned
Jul 10, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 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 RPH025170 GA Primary

Addresses

Primary practice location

4250 Roswell Rd
Marietta, GA 30062-6498

Mailing address

285 Van Mar Dr
Wytheville, VA 24382-4136
Phone (732) 618-3965

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
RPH025170GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278720000000",
    "number": "1992017651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 VAN MAR DR",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243824136",
            "telephone_number": "732-618-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 ROSWELL RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626498",
            "telephone_number": "770-565-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDADI",
        "first_name": "SWETHA",
        "middle_name": "REDDY",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-10",
        "last_updated": "2010-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH025170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.