Active NPI
Demetri Antonio Boston, RPH
- Pharmacist
- Staunton, VA
National Provider Identifier
1215524145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202218540
- Practice address
- 1302 Barterbrook Rd
Staunton, VA 24401-5013 - Phone
- (540) 886-2361
- NPI assigned
- Dec 27, 2020
- 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 | 0202218540 | VA | Primary |
Addresses
Primary practice location
1302 Barterbrook Rd
Staunton, VA 24401-5013
Mailing address
357 Windigrove Dr Apt 1026
Waynesboro, VA 22980-7598
Phone (757) 510-4979
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 |
|---|---|---|---|
| 0202218540 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609027200000",
"number": "1215524145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "357 WINDIGROVE DR APT 1026",
"city": "WAYNESBORO",
"state": "VA",
"postal_code": "229807598",
"telephone_number": "757-510-4979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1302 BARTERBROOK RD",
"city": "STAUNTON",
"state": "VA",
"postal_code": "244015013",
"telephone_number": "540-886-2361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSTON",
"first_name": "DEMETRI",
"middle_name": "ANTONIO",
"name_prefix": "Dr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-27",
"last_updated": "2020-12-27",
"certification_date": "2020-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202218540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staunton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.