Individual provider Active NPI

John Anthony Petracci, R.PH

  • Pharmacist
  • Youngstown, OH
National Provider Identifier
1013906361
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03316874 Issued in OH
Practice address
602 Parmalee Ave
Suite 100
Youngstown, OH 44510-1653
Phone
(330) 746-2657
Fax
(330) 746-0014
NPI assigned
Oct 19, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03316874 OH Primary
Pharmacist 183500000X PS23764 FL

Addresses

Primary practice location

602 Parmalee Ave
Suite 100
Youngstown, OH 44510-1653

Mailing address

602 Parmalee Ave
Suite 100
Youngstown, OH 44510-1653
Phone (330) 746-2657

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
PS23764FLMDPharmacist
03316874OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Pharmacy Group Inc Current Accepting new patients
Independent Pharmacy Group Inc Current Accepting new patients

Locations

602 Parmalee Ave
Ste 100
Youngstown, OH 44510
Phone (330) 746-2657

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1013906361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 PARMALEE AVE",
            "address_2": "SUITE 100",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101653",
            "telephone_number": "330-746-2657",
            "fax_number": "330-746-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 PARMALEE AVE",
            "address_2": "SUITE 100",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101653",
            "telephone_number": "330-746-2657",
            "fax_number": "330-746-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRACCI",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03316874",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS23764",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.