Individual provider Active NPI

Derek James Wetsch, PHARMD

  • Pharmacist
  • Elkins, WV
National Provider Identifier
1003482464
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP0009419 Issued in WV
Practice address
615 Randolph Ave
Elkins, WV 26241-3950
Phone
(304) 636-8180
NPI assigned
May 27, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP0009419 WV Primary

Addresses

Primary practice location

615 Randolph Ave
Elkins, WV 26241-3950

Mailing address

345 Maple LN
Elkins, WV 26241-7282
Phone (304) 614-2752

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RP0009419WVMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1003482464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 MAPLE LN",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "262417282",
            "telephone_number": "304-614-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 RANDOLPH AVE",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "262413950",
            "telephone_number": "304-636-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETSCH",
        "first_name": "DEREK",
        "middle_name": "JAMES",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP0009419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkins, WV

Sources for this page

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