Active NPI
Chimaobi Chukwu
- Pharmacist
- Boston, MA
National Provider Identifier
1063003853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH235477
- Practice address
- 278 Blue Hill Ave
St. 288
Boston, MA 02119 - Phone
- (617) 652-7679
- Fax
- (857) 308-3440
- NPI assigned
- Feb 3, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH235477 | MA | Primary |
Addresses
Primary practice location
278 Blue Hill Ave
St. 288
Boston, MA 02119
Mailing address
17 Michelle LN
Randolph, MA 02368-1526
Phone (617) 291-8144
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PH235477 | Other | MA | PHARMACIST LICENSE NUMBER |
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 |
|---|---|---|---|
| PH235477 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612310400000",
"number": "1063003853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 MICHELLE LN",
"city": "RANDOLPH",
"state": "MA",
"postal_code": "023681526",
"telephone_number": "617-291-8144",
"fax_number": "857-308-3440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "278 BLUE HILL AVE",
"address_2": "ST. 288",
"city": "BOSTON",
"state": "MA",
"postal_code": "02119",
"telephone_number": "617-652-7679",
"fax_number": "857-308-3440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUKWU",
"first_name": "CHIMAOBI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-02-03",
"last_updated": "2021-02-03",
"certification_date": "2021-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH235477",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE NUMBER",
"identifier": "PH235477",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.