Active NPI
Antonie Homer, RPH
- Pharmacist
- Fredericksburg, VA
National Provider Identifier
1154877322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202214925
- Practice address
- 10809 Tidewater TRL
Fredericksburg, VA 22408-2048 - Phone
- (540) 368-3390
- NPI assigned
- Aug 28, 2016
- Sex
- Male
- Sole proprietor
- No
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 | 0202214925 | VA | Primary |
Addresses
Primary practice location
10809 Tidewater TRL
Fredericksburg, VA 22408-2048
Mailing address
10809 Tidewater TRL
Fredericksburg, VA 22408-2048
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 |
|---|---|---|---|
| 0202214925 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virginia CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Virginia CVS Pharmacy, L.L.C. | 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.
-
- Pharmacy
- Charlottesville, VA
- NPI 1053415711
-
- Pharmacy
- Fredericksburg, VA
- NPI 1174664478
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472342400000",
"number": "1154877322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10809 TIDEWATER TRL",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224082048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10809 TIDEWATER TRL",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224082048",
"telephone_number": "540-368-3390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOMER",
"first_name": "ANTONIE",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-28",
"last_updated": "2016-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202214925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.