Active NPI
Mitchell Chan, PHARM.D
- Pharmacist
- Wakefield, RI
National Provider Identifier
1295105286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH05484
- Practice address
- 100 Kenyon Ave
Wakefield, RI 02879-4216 - Phone
- (401) 788-1454
- NPI assigned
- Oct 2, 2015
- Last updated
- Oct 2, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 | RPH05484 | RI | Primary |
Addresses
Primary practice location
100 Kenyon Ave
Wakefield, RI 02879-4216
Mailing address
100 Kenyon Ave
Wakefield, RI 02879-4216
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 |
|---|---|---|---|
| RPH05484 | RI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443744000000",
"number": "1295105286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 KENYON AVE",
"city": "WAKEFIELD",
"state": "RI",
"postal_code": "028794216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 KENYON AVE",
"city": "WAKEFIELD",
"state": "RI",
"postal_code": "028794216",
"telephone_number": "401-788-1454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "MITCHELL",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-10-02",
"last_updated": "2015-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "RI",
"license": "RPH05484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wakefield, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.