Individual provider Active NPI

Chrisita Ackermann, PHD

  • Pharmacist
  • Melbourne, FL
National Provider Identifier
1134498660
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS57093 Issued in FL
Practice address
447 Lake Victoria Cir
Melbourne, FL 32940-1873
Phone
(734) 904-2529
NPI assigned
Dec 29, 2011
Last updated
Aug 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302039013 MI
Pharmacist 183500000X PS57093 FL Primary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PU8543 FL

Addresses

Primary practice location

447 Lake Victoria Cir
Melbourne, FL 32940-1873

Mailing address

447 Lake Victoria Cir
Melbourne, FL 32940-1873
Phone (734) 904-2529

Other practice location 1

309 Killarney Beach Rd
Bay City, MI 48706-1108
Phone (989) 391-9261

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 Philosophy

State licenses

LicenseStateTypeSpecialty
PS57093FLMDPharmacist
5302039013MIMDPharmacist
PU8543FLMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated RX Outcomes Inc CurrentSince Aug 30, 2020 Accepting new patients

Organizations & group practices 1

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": "1325116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1134498660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 LAKE VICTORIA CIR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401873",
            "telephone_number": "734-904-2529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 LAKE VICTORIA CIR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401873",
            "telephone_number": "734-904-2529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 Killarney Beach Rd",
            "address_purpose": "LOCATION",
            "city": "Bay City",
            "state": "MI",
            "postal_code": "487061108",
            "country_code": "US",
            "telephone_number": "989-391-9261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACKERMANN",
        "first_name": "CHRISITA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-29",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302039013",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS57093",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "PU8543",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.