Active NPI
Kevin Pelter, PHARMD, RPH
- Pharmacist
- Sycamore, OH
National Provider Identifier
1093386906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03131801
- Practice address
- 119 S Sycamore Avenue
Sycamore, OH 44882 - Phone
- (419) 927-2691
- NPI assigned
- Jul 2, 2021
- Last updated
- Jul 2, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03131801 | OH | Primary |
Addresses
Primary practice location
119 S Sycamore Avenue
Sycamore, OH 44882
Mailing address
PO Box 107
Sycamore, OH 44882-0107
Phone (419) 927-2691
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
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03131801 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fillmore Pharmacy LLC | Current | Accepting new patients | |
| Donald C Fillmore | Past | Accepting new patients |
Organizations & group practices 2
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": "1625184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625184000000",
"number": "1093386906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 107",
"city": "SYCAMORE",
"state": "OH",
"postal_code": "448820107",
"telephone_number": "419-927-2691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 S SYCAMORE AVENUE",
"city": "SYCAMORE",
"state": "OH",
"postal_code": "44882",
"telephone_number": "419-927-2691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELTER",
"first_name": "KEVIN",
"credential": "PHARMD, RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-02",
"last_updated": "2021-07-02",
"certification_date": "2021-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03131801",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sycamore, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.