Individual provider Active NPI

Shiddharth Patel, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Rockville, MD
National Provider Identifier
1134870553
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
25703 Issued in MD
Practice address
184 Rollins Ave
Rockville, MD 20852-4005
Phone
(301) 816-2801
NPI assigned
Jan 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 25703 MD Primary

Addresses

Primary practice location

184 Rollins Ave
Rockville, MD 20852-4005

Mailing address

1628 E Jefferson St Unit 403
Rockville, MD 20852-3253

Other practice location 1

184 Rollins Ave
Rockville, MD 20852
Phone (301) 816-2801

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

State licenses

LicenseStateTypeSpecialty
25703MDMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellrock Pharmacy LLC Current Accepting new patients
Wellrock Pharmacy LLC Current Accepting new patients
Rollins Care Pharmacy LLC PastSince Jan 26, 2022 Accepting new patients

Organizations & group practices 3

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": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1134870553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 E JEFFERSON ST UNIT 403",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 ROLLINS AVE",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524005",
            "telephone_number": "301-816-2801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "184 Rollins Ave",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "20852",
            "country_code": "US",
            "telephone_number": "301-816-2801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHIDDHARTH",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MD",
            "license": "25703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.