Individual provider Active NPI

Penni Anne Cheatle, RPH

  • Pharmacist
  • Bristol, CT
National Provider Identifier
1306282884
Registry record updated May 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
8746 Issued in CT
Practice address
160 Indiana St
Bristol, CT 06010-9138
Phone
(860) 585-5478
NPI assigned
May 10, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8746 CT Primary

Addresses

Primary practice location

160 Indiana St
Bristol, CT 06010-9138

Mailing address

160 Indiana St
Bristol, CT 06010-9138
Phone (860) 585-5478

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
8746CTMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1368144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368144000000",
    "number": "1306282884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 INDIANA ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060109138",
            "telephone_number": "860-585-5478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 INDIANA ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060109138",
            "telephone_number": "860-585-5478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEATLE",
        "first_name": "PENNI",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-10",
        "last_updated": "2013-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "8746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; 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.