Active NPI
Beltus Simo, RPH
- Pharmacist
- Bowie, MD
National Provider Identifier
1053911636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18132
- Practice address
- 3300 Crain Hwy
Bowie, MD 20716-1398 - Phone
- (301) 805-8853
- NPI assigned
- Oct 31, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 18132 | MD | |
| Pharmacist | 183500000X | 18132 | MD | Primary |
Addresses
Primary practice location
3300 Crain Hwy
Bowie, MD 20716-1398
Mailing address
8607 Crooked Tree LN
Laurel, MD 20724-2478
Phone (240) 476-2356
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18132 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604102400000",
"number": "1053911636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8607 CROOKED TREE LN",
"city": "LAUREL",
"state": "MD",
"postal_code": "207242478",
"telephone_number": "240-476-2356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 CRAIN HWY",
"city": "BOWIE",
"state": "MD",
"postal_code": "207161398",
"telephone_number": "301-805-8853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMO",
"first_name": "BELTUS",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-31",
"last_updated": "2020-10-31",
"certification_date": "2020-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "MD",
"license": "18132",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "18132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.