Individual provider Active NPI

Peter Joseph Elliott, PHARMD

  • Pharmacist
  • Des Moines, IA
National Provider Identifier
1053930149
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
22580 Issued in IA
Practice address
3221 SE 14TH St
Des Moines, IA 50320-1304
Phone
(515) 246-1390
NPI assigned
Apr 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 22580 IA Primary

Addresses

Primary practice location

3221 SE 14TH St
Des Moines, IA 50320-1304

Mailing address

3221 SE 14TH St
Des Moines, IA 50320-1304
Phone (515) 246-1390

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 1142pharmacydept@hy-vee.com Direct Hy-Vee Inc

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
22580IAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1053930149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 SE 14TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503201304",
            "telephone_number": "515-246-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3221 SE 14TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503201304",
            "telephone_number": "515-246-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2023-11-27",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "22580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "1142pharmacydept@hy-vee.com",
            "affiliation": "Y",
            "endpointDescription": "Outlook email",
            "affiliationName": "Hy-Vee Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3221 SE 14th St",
            "city": "Des Moines",
            "state": "IA",
            "country_code": "US",
            "postal_code": "503201304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.