Individual provider Active NPI

Ryker Justin Verelst

  • Community/Retail Pharmacy
  • Framingham, MA
National Provider Identifier
1063292902
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH996992 Issued in MA
Practice address
624 Waverley St
Framingham, MA 01702-6981
Phone
(508) 935-2201
NPI assigned
Sep 28, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PH996992 MA Primary

Addresses

Primary practice location

624 Waverley St
Framingham, MA 01702-6981

Mailing address

145 Front St Unit 1142
Worcester, MA 01608-1447
Phone (413) 523-6582

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

LicenseStateTypeSpecialty
PH996992MAMDCommunity/Retail Pharmacy

NPI Registry JSON

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1063292902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 FRONT ST UNIT 1142",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081447",
            "telephone_number": "413-523-6582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 WAVERLEY ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017026981",
            "telephone_number": "508-935-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERELST",
        "first_name": "RYKER",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "PH996992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Framingham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.