Active NPI
Kevin Whelan, RPH
- Pharmacist
- Lauderdale by the Sea, FL
National Provider Identifier
1114394038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS26103
- Practice address
- 4467 Poinciana St
Lauderdale by the Sea, FL 33308-4414 - Phone
- (954) 257-0868
- NPI assigned
- Aug 26, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 | PS26103 | FL | Primary |
Addresses
Primary practice location
4467 Poinciana St
Lauderdale by the Sea, FL 33308-4414
Mailing address
4467 Poinciana St
Lauderdale by the Sea, FL 33308-4414
Phone (954) 257-0868
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS26103 | Other | FL | PHARMACIST |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS26103 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440547200000",
"number": "1114394038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4467 POINCIANA ST",
"city": "LAUDERDALE BY THE SEA",
"state": "FL",
"postal_code": "333084414",
"telephone_number": "954-257-0868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4467 POINCIANA ST",
"city": "LAUDERDALE BY THE SEA",
"state": "FL",
"postal_code": "333084414",
"telephone_number": "954-257-0868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHELAN",
"first_name": "KEVIN",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-26",
"last_updated": "2015-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS26103",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST",
"identifier": "PS26103",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lauderdale by the Sea, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.