Individual provider Active NPI

John Lee, R. PH.

  • Pharmacist
  • Bakersfield, CA
National Provider Identifier
1063402089
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH22347 Issued in CA
Practice address
2191 Niles St
Bakersfield, CA 93305-5007
Phone
(661) 327-4248
Fax
(661) 327-1025
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH22347 CA Primary

Addresses

Primary practice location

2191 Niles St
Bakersfield, CA 93305-5007

Mailing address

2191 Niles St
Bakersfield, CA 93305-5007
Phone (661) 327-4248

Other identifiers 2

IdentifierTypeStateIssuer
1033109319MedicaidCA
0524719OtherCANCPDP 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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH22347CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Spray Pharmacy Current Accepting new patients

Locations

2191 Niles St
Bakersfield, CA 93305
Phone (661) 327-4248

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1063402089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 NILES ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933055007",
            "telephone_number": "661-327-4248",
            "fax_number": "661-327-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2191 NILES ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933055007",
            "telephone_number": "661-327-4248",
            "fax_number": "661-327-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "R. PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH22347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033109319",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "0524719",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.