Active NPI
Derrick Smith, RPH
- Pharmacist
- Plymouth, MA
National Provider Identifier
1063017465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH234586
- Practice address
- 517 State Rd
Plymouth, MA 02360-5110 - Phone
- (508) 224-3312
- NPI assigned
- Dec 2, 2020
- Sex
- Male
- 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 | PH234586 | MA | Primary |
Addresses
Primary practice location
517 State Rd
Plymouth, MA 02360-5110
Mailing address
517 State Rd
Plymouth, MA 02360-5110
Phone (505) 224-3312
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | RX01867@cvshealth.com | Direct |
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 |
|---|---|---|---|
| PH234586 | MA | MD | Pharmacist |
Interoperability endpoints
- rx01867@cvshealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606867200000",
"number": "1063017465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "517 STATE RD",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023605110",
"telephone_number": "505-224-3312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "517 STATE RD",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023605110",
"telephone_number": "508-224-3312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "DERRICK",
"name_prefix": "Dr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-02",
"last_updated": "2020-12-02",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH234586",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "RX01867@cvshealth.com",
"affiliation": "N",
"endpointDescription": "CVS store email",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "517 State Rd",
"city": "Plymouth",
"state": "MA",
"country_code": "US",
"postal_code": "023605110",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Plymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.