Individual provider Active NPI

Philip Donald McIntyre, R. PH.

  • Pharmacist
  • State College, PA
National Provider Identifier
1215949763
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP030163L Issued in PA
Practice address
724 S Atherton St
Suite 100
State College, PA 16801-4628
Phone
(814) 238-2712
Fax
(814) 238-0480
NPI assigned
Aug 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP030163L PA Primary

Addresses

Primary practice location

724 S Atherton St
Suite 100
State College, PA 16801-4628

Mailing address

724 S Atherton St
Suite 100
State College, PA 16801-4628
Phone (814) 238-2712

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
RP030163LPAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215949763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 S ATHERTON ST",
            "address_2": "SUITE 100",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168014628",
            "telephone_number": "814-238-2712",
            "fax_number": "814-238-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 S ATHERTON ST",
            "address_2": "SUITE 100",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168014628",
            "telephone_number": "814-238-2712",
            "fax_number": "814-238-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "PHILIP",
        "middle_name": "DONALD",
        "name_prefix": "Mr.",
        "credential": "R. PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP030163L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.