Patra Kositchaiwat Gilbert, MBA, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

17844 Issued in OK

Practice address

2323 N Martin Luther King Ave
Oklahoma City, OK 73111-2496

Phone

(405) 424-0557

Fax

(405) 424-0105

NPI assigned

Nov 21, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Patra Kositchaiwat Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration, Doctor of Pharmacy

State licenses

Practice roles

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.

• Oklahoma CVS Pharmacy LLC

  • Pharmacy
  • Enid, OK
  • NPI 1407278260
  NPD (past)
• Oklahoma CVS Pharmacy LLC

  • Pharmacy
  • Oklahoma City, OK
  • NPI 1669576492
  NPD (past)

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1104395920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 N MARTIN LUTHER KING AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731112496",
            "telephone_number": "405-424-0557",
            "fax_number": "405-424-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 N MARTIN LUTHER KING AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731112496",
            "telephone_number": "405-424-0557",
            "fax_number": "405-424-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "PATRA",
        "middle_name": "KOSITCHAIWAT",
        "name_prefix": "Dr.",
        "credential": "MBA, PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "17844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRA",
            "last_name": "KOSITCHAIWAT",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erin Gilbert, RBT
• James Gilbert
• Khalilah Gilbert
• Larry Gilbert
• Michael D Gilbert Sr.
• Shae Gilbert
• Tarra Gaynell Gilbert, M.A.
• Chelsey Dee Gilbertson, D.O.
• Chasidy Gilbreath, BSN
• Damion Dwan Gilbreath I

• Pharmacist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Pharmacist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; 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.