Individual provider Active NPI

Drew Thomas Pentland, PHARM D

  • Pharmacist
  • Waterloo, IL
National Provider Identifier
1013512045
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH6005 Issued in ND
Practice address
150 Waterloo Commons Dr
Waterloo, IL 62298-1081
Phone
(618) 939-3942
NPI assigned
Nov 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2017037466 MO
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 051.303339 IL
Pharmacist 183500000X RPH6005 ND Primary

Addresses

Primary practice location

150 Waterloo Commons Dr
Waterloo, IL 62298-1081

Mailing address

150 Waterloo Commons Dr
Waterloo, IL 62298-1081
Phone (618) 939-3942

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
2017037466MOMDPharmacist
RPH6005NDMDPharmacist
051.303339ILMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1013512045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 WATERLOO COMMONS DR",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981081",
            "telephone_number": "618-939-3942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 WATERLOO COMMONS DR",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981081",
            "telephone_number": "618-939-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTLAND",
        "first_name": "DREW",
        "middle_name": "THOMAS",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2017037466",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IL",
            "license": "051.303339",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "RPH6005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.