Individual provider Active NPI

Philip M McRae, MS, RPH

  • Pharmacist
  • Santa Rosa, CA
National Provider Identifier
1285722546
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH 25588 Issued in CA
Practice address
4823 Skycrest Way
Santa Rosa, CA 95405-8798
Phone
(707) 571-4784
Fax
(707) 571-4701
NPI assigned
Oct 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 RPH 25588 CA Primary

Addresses

Primary practice location

4823 Skycrest Way
Santa Rosa, CA 95405-8798

Mailing address

4823 Skycrest Way
Santa Rosa, CA 95405-8798
Phone (707) 571-4184

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
Master of Science, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH 25588CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285722546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4823 SKYCREST WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954058798",
            "telephone_number": "707-571-4184",
            "fax_number": "707-571-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4823 SKYCREST WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954058798",
            "telephone_number": "707-571-4784",
            "fax_number": "707-571-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCRAE",
        "first_name": "PHILIP",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MS, RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH 25588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

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.