Penny Jean Gehrs Nerderman

Primary specialty

PharmacistTaxonomy code 183500000X

License

03120595 Issued in OH

Practice address

75 W Central Ave
Camden, OH 45311-1007

Phone

(513) 571-3681

Fax

(937) 452-3957

NPI assigned

Aug 20, 2018

Sex

Female

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Perry Pharmacy Enterprise LLC

  • Community/Retail Pharmacy
  • Camden, OH
  • NPI 1194484493
  NPD
• Perry Pharmacy Enterprise LLC

  • Community/Retail Pharmacy
  • Camden, OH
  • NPI 1871675678
  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 29, 2021.

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1003396060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6286 WOODWIND CT",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450448864",
            "telephone_number": "513-571-3681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 W CENTRAL AVE",
            "city": "CAMDEN",
            "state": "OH",
            "postal_code": "453111007",
            "telephone_number": "513-571-3681",
            "fax_number": "937-452-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NERDERMAN",
        "first_name": "PENNY",
        "middle_name": "JEAN GEHRS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03120595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "03120595",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• McCullough Hyde Memorial Hospital Inc
• McCullough-Hyde Memorial Hospital Incorporated
• Medship LLC
• Shaun Joseph Mienko
• Maggie Moore
• Megan M Nichting
• Cora Lyn Niehoff
• Our Happy Home LLC
• Perry Pharmacy Enterprise LLC
• Perry Pharmacy Enterprise LLC

• All providers in Camden, OH
• Pharmacist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.