Individual provider Active NPI

Chinedu Ikpemo

  • Pharmacist
  • Pasadena, MD
National Provider Identifier
1063968261
Registry record updated Aug 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21198 Issued in MD
Practice address
8051 Fort Smallwood Rd
Pasadena, MD 21122
Phone
(410) 437-1149
NPI assigned
Aug 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21198 MD Primary

Addresses

Primary practice location

8051 Fort Smallwood Rd
Pasadena, MD 21122

Mailing address

310 Jena Cir Apt 302
Odenton, MD 21113-3295

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
21198MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472342400000",
    "number": "1063968261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 JENA CIR APT 302",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211133295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8051 FORT SMALLWOOD RD",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "21122",
            "telephone_number": "410-437-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKPEMO",
        "first_name": "CHINEDU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "21198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; 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.