Active NPI
Larisa Petkeviciene, PHARMACIST
- Pharmacist
- Maysville, KY
National Provider Identifier
1023324043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 015113
- Practice address
- 1160 U.S 68
Maysville, KY 41056-9125 - Phone
- (606) 564-4044
- NPI assigned
- Aug 27, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 015113 | KY | Primary |
Addresses
Primary practice location
1160 U.S 68
Maysville, KY 41056-9125
Mailing address
1160 US 68
Maysville, KY 41056-9125
Phone (606) 564-4044
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015113 | KY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391040000000",
"number": "1023324043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1160 US 68",
"city": "MAYSVILLE",
"state": "KY",
"postal_code": "410569125",
"telephone_number": "606-564-4044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1160 U.S 68",
"city": "MAYSVILLE",
"state": "KY",
"postal_code": "410569125",
"telephone_number": "606-564-4044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETKEVICIENE",
"first_name": "LARISA",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-27",
"last_updated": "2014-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "015113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maysville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.