Individual provider Active NPI

Robert Spada, RPH

  • Pharmacist
  • El Dorado Hills, CA
National Provider Identifier
1114383601
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
41891 Issued in CA
Practice address
4400 Latrobe Rd
El Dorado Hills, CA 95762-6704
Phone
(916) 934-0133
NPI assigned
Jan 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 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 41891 CA Primary

Addresses

Primary practice location

4400 Latrobe Rd
El Dorado Hills, CA 95762-6704

Mailing address

4400 Latrobe Rd
El Dorado Hills, CA 95762-6704

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
41891CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Longs Drug Stores California LLC PastSince Apr 19, 2020 Accepting new patients
Longs Drug Store California LLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1114383601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 LATROBE RD",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957626704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 LATROBE RD",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957626704",
            "telephone_number": "916-934-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPADA",
        "first_name": "ROBERT",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "41891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.