Individual provider Active NPI

David Russell Gutekunst, RPH

  • Pharmacist
  • Harleysville, PA
National Provider Identifier
1336137017
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP031185L Issued in PA
Practice address
2700 Shelly Rd
Harleysville, PA 19438-1281
Phone
(215) 513-3053
Fax
(215) 513-3052
NPI assigned
Oct 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP031185L PA Primary
Pharmacist 183500000X A10002778 DE

Addresses

Primary practice location

2700 Shelly Rd
Harleysville, PA 19438-1281

Mailing address

2700 Shelly Rd
Harleysville, PA 19438-1201
Phone (215) 513-3053

Other identifiers 6

IdentifierTypeStateIssuer
0018678030002MedicaidPA
PP481624OtherPAPA PERMIT
3986962OtherNCPDP
4415720002OtherPANSC
1558469486OtherNPI
4415720002OtherPAMEDICARE NSC

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
A10002778DEMDPharmacist
RP031185LPAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Landis Super Market Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1336137017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 SHELLY RD",
            "city": "HARLEYSVILLE",
            "state": "PA",
            "postal_code": "194381201",
            "telephone_number": "215-513-3053",
            "fax_number": "215-513-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 SHELLY RD",
            "city": "HARLEYSVILLE",
            "state": "PA",
            "postal_code": "194381281",
            "telephone_number": "215-513-3053",
            "fax_number": "215-513-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTEKUNST",
        "first_name": "DAVID",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP031185L",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "DE",
            "license": "A10002778",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018678030002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA PERMIT",
            "identifier": "PP481624",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3986962",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC",
            "identifier": "4415720002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1558469486",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC",
            "identifier": "4415720002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harleysville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.