Active NPI
Deedee Ibeku
- Pharmacist
- Wallingford, CT
National Provider Identifier
1043931314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH033909
- Practice address
- 605 N Colony Rd
Wallingford, CT 06492-3109 - Phone
- (203) 265-3600
- NPI assigned
- Sep 6, 2022
- 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 | RPH033909 | GA | Primary |
Addresses
Primary practice location
605 N Colony Rd
Wallingford, CT 06492-3109
Mailing address
605 N Colony Rd
Wallingford, CT 06492-3109
Other names 1
- Dr. Deedee Ibeku
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | NA |
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 |
|---|---|---|---|
| RPH033909 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifecare Family Doctors, PC | Current | Accepting new patients | |
| Rite Aid of Connecticut Inc | Past | Accepting new patients | |
| Rite Aid of Connecticut Inc | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Union, NJ
- NPI 1952349532
-
- Community/Retail Pharmacy
- Wallingford, CT
- NPI 1295844678
-
- Community/Retail Pharmacy
- New Haven, CT
- NPI 1326411570
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662422400000",
"number": "1043931314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 N COLONY RD",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "064923109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 N COLONY RD",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "064923109",
"telephone_number": "203-265-3600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBEKU",
"first_name": "DEEDEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-06",
"last_updated": "2022-09-06",
"certification_date": "2022-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH033909",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "NA",
"affiliation": "N",
"address_1": "605 N Colony Rd",
"city": "Wallingford",
"state": "CT",
"country_code": "US",
"postal_code": "064923109",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "DEEDEE",
"last_name": "IBEKU",
"prefix": "DR.",
"credential": "PHARM.D",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Wallingford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.