Individual provider Active NPI

Gregory Oluremi Fakorede

  • Pharmacist
  • Severn, MD
National Provider Identifier
1194139428
Registry record updated Jun 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19304 Issued in MD
Practice address
7851 Telegraph Rd
Severn, MD 21144-1831
Phone
(410) 551-5141
Fax
(410) 551-5141
NPI assigned
Jun 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19304 MD Primary

Addresses

Primary practice location

7851 Telegraph Rd
Severn, MD 21144-1831

Mailing address

7851 Telegraph Rd
Severn, MD 21144-1831
Phone (410) 551-5141

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

State licenses

LicenseStateTypeSpecialty
19304MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland CVS Pharmacy LLC Past Accepting new patients
Maryland 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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402704000000",
    "number": "1194139428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7851 TELEGRAPH RD",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211441831",
            "telephone_number": "410-551-5141",
            "fax_number": "410-551-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7851 TELEGRAPH RD",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211441831",
            "telephone_number": "410-551-5141",
            "fax_number": "410-551-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKOREDE",
        "first_name": "GREGORY",
        "middle_name": "OLUREMI",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-14",
        "last_updated": "2014-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "19304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severn, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2014; 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.