Individual provider Active NPI

Indira Devarasetty

  • Pharmacist
  • Jacksonville, FL
National Provider Identifier
1992116743
Registry record updated May 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS43316 Issued in FL
Practice address
8428 Highgate Dr
Jacksonville, FL 32216-1479
Phone
(973) 960-7232
NPI assigned
May 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 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 PS43316 FL Primary

Addresses

Primary practice location

8428 Highgate Dr
Jacksonville, FL 32216-1479

Mailing address

8428 Highgate Dr
Jacksonville, FL 32216-1479

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

LicenseStateTypeSpecialty
PS43316FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400025600000",
    "number": "1992116743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8428 HIGHGATE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8428 HIGHGATE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161479",
            "telephone_number": "973-960-7232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVARASETTY",
        "first_name": "INDIRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2014-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS43316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.