Individual provider Active NPI

John Thomas Palaika, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Plymouth, IN
National Provider Identifier
1043850407
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
26028423A Issued in IN
Practice address
2001 N Michigan St
Plymouth, IN 46563-1020
Phone
(574) 936-2040
NPI assigned
Jan 13, 2020
Last updated
Jan 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 26028423A IN Primary

Addresses

Primary practice location

2001 N Michigan St
Plymouth, IN 46563-1020

Mailing address

938 Hamilton Ave
Latrobe, PA 15650-1601
Phone (724) 972-2760

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
26028423AINMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1043850407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "938 HAMILTON AVE",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156501601",
            "telephone_number": "724-972-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N MICHIGAN ST",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465631020",
            "telephone_number": "574-936-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALAIKA",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-13",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IN",
            "license": "26028423A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, IN

Sources for this page

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