Active NPI
Peter Agene, B. PHARM
- Pharmacist
- Virginia Beach, VA
National Provider Identifier
1215219787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202207953
- Practice address
- 1101 Nimmo Pkwy
Virginia Beach, VA 23456-7730 - Phone
- (757) 427-1655
- Fax
- (757) 427-1514
- NPI assigned
- Sep 12, 2011
- 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 | 0202207953 | VA | Primary |
Addresses
Primary practice location
1101 Nimmo Pkwy
Virginia Beach, VA 23456-7730
Mailing address
1101 Nimmo Parkway
Virginia Beach, VA 23456
Phone (757) 427-1655
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0202207953 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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
- Virginia Beach, VA
- NPI 1346257375
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315785600000",
"number": "1215219787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 NIMMO PARKWAY",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "23456",
"telephone_number": "757-427-1655",
"fax_number": "757-427-1514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 NIMMO PKWY",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234567730",
"telephone_number": "757-427-1655",
"fax_number": "757-427-1514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGENE",
"first_name": "PETER",
"credential": "B. PHARM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-12",
"last_updated": "2011-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202207953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.