Individual provider Active NPI

Derrick Smith, RPH

  • Pharmacist
  • Plymouth, MA
National Provider Identifier
1063017465
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH234586 Issued in MA
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

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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

LicenseStateTypeSpecialty
PH234586MAMDPharmacist

Interoperability endpoints

  • Direct secure messaging: 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.

Verify at the official NPI Registry.