Individual provider Active NPI

Bonnie B Gazda, RPH

  • Pharmacist
  • Philadelphia, PA
National Provider Identifier
1205946597
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP029412L Issued in PA
Practice address
833 Chestnut St
Suite 125
Philadelphia, PA 19107-4414
Phone
(215) 955-4400
Fax
(215) 503-1580
NPI assigned
Aug 30, 2006
Last updated
Feb 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP029412L PA Primary

Addresses

Primary practice location

833 Chestnut St
Suite 125
Philadelphia, PA 19107-4414

Mailing address

833 Chestnut St
Suite 125
Philadelphia, PA 19107-4414
Phone (215) 955-8338

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

LicenseStateTypeSpecialty
RP029412LPAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffex Inc 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, 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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1205946597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST",
            "address_2": "SUITE 125",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074414",
            "telephone_number": "215-955-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST",
            "address_2": "SUITE 125",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074414",
            "telephone_number": "215-955-4400",
            "fax_number": "215-503-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZDA",
        "first_name": "BONNIE",
        "middle_name": "B",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP029412L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.