Individual provider Active NPI

Ketan C Naik, RPH

  • Pharmacist
  • Plano, TX
National Provider Identifier
1013041854
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
31258 Issued in TX
Practice address
8621 Ohio Dr
Plano, TX 75024-2264
Phone
(469) 633-0041
NPI assigned
Mar 15, 2007
Reactivated
Feb 21, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 31258 TX Primary

Addresses

Primary practice location

8621 Ohio Dr
Plano, TX 75024-2264

Mailing address

8621 Ohio Dr
Plano, TX 75024-2264
Phone (469) 633-0041

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
31258TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1013041854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8621 OHIO DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242264",
            "telephone_number": "469-633-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8621 OHIO DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242264",
            "telephone_number": "469-633-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIK",
        "first_name": "KETAN",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "deactivation_date": "2011-04-18",
        "reactivation_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "31258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.