Individual provider Active NPI

Ervin Counts, PHARMACIST

  • Pharmacist
  • Haysi, VA
National Provider Identifier
1073104543
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202010366 Issued in VA
Practice address
164 Haysi Main Street
Haysi, VA 24256
Phone
(276) 865-5560
Fax
(276) 865-5310
NPI assigned
Jan 28, 2021
Last updated
Jun 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 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 0202010366 VA Primary

Addresses

Primary practice location

164 Haysi Main Street
Haysi, VA 24256

Mailing address

PO Box 147
Birchleaf, VA 24220-0147
Phone (276) 865-0204

Other identifiers 1

IdentifierTypeStateIssuer
0202010366OtherVABOARD OF PHARMACY

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
0202010366VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Russell Fork Pharmacies, Inc. CurrentSince Jan 1, 2021 Accepting new patients
Wytheville Pharmacy LLC Current Accepting new patients
New River Pharmacy LLC Current Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1073104543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 147",
            "city": "BIRCHLEAF",
            "state": "VA",
            "postal_code": "242200147",
            "telephone_number": "276-865-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 HAYSI MAIN STREET",
            "city": "HAYSI",
            "state": "VA",
            "postal_code": "24256",
            "telephone_number": "276-865-5560",
            "fax_number": "276-865-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUNTS",
        "first_name": "ERVIN",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202010366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "0202010366",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haysi, VA

Sources for this page

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