Individual provider Active NPI

Thomas Jon Ravis, PHARM D

  • Pharmacist
  • Weston, WV
National Provider Identifier
1235474636
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP0008023 Issued in WV
Practice address
4 Garton PLZ
Weston, WV 26452-2129
Phone
(304) 269-3737
Fax
(304) 269-3770
NPI assigned
Dec 11, 2012
Last updated
Dec 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP0008023 WV Primary

Addresses

Primary practice location

4 Garton PLZ
Weston, WV 26452-2129

Mailing address

4 Garton PLZ
Weston, WV 26452-2129
Phone (304) 269-3737

Other identifiers 1

IdentifierTypeStateIssuer
3810001887MedicaidWV

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

LicenseStateTypeSpecialty
RP0008023WVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Fast & Friendly Pharmacy RC LLC PastSince May 29, 2022 Accepting new patients
Best Care Pharmacy 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": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1235474636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GARTON PLZ",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "264522129",
            "telephone_number": "304-269-3737",
            "fax_number": "304-269-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GARTON PLZ",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "264522129",
            "telephone_number": "304-269-3737",
            "fax_number": "304-269-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVIS",
        "first_name": "THOMAS",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-11",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP0008023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001887",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; 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.