Individual provider Active NPI

Chan Sok Nam, PHARMD

  • Pharmacist
  • Clifton, NJ
National Provider Identifier
1154918464
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03460500 Issued in NJ
Practice address
160 Kingsland Rd
Clifton, NJ 07014-1915
Phone
(973) 779-6697
NPI assigned
Dec 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03460500 NJ Primary

Addresses

Primary practice location

160 Kingsland Rd
Clifton, NJ 07014-1915

Mailing address

319A 7TH St
Palisades Park, NJ 07650-2279
Phone (201) 835-6464

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chansok.nam@stopandshop.com Direct

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
28RI03460500NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
The Stop & Shop Supermarket Company LLC PastSince Dec 27, 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": "1608595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1154918464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319A 7TH ST",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076502279",
            "telephone_number": "201-835-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 KINGSLAND RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070141915",
            "telephone_number": "973-779-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAM",
        "first_name": "CHAN SOK",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03460500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chansok.nam@stopandshop.com",
            "affiliation": "N",
            "endpointDescription": "Pharmacy email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "160 Kingsland Rd",
            "city": "Clifton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070141915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.