Bevis Vanterpool, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PP481991 Issued in PA

Practice address

4839 N Broad St
Philadelphia, PA 19141-2107

Phone

(215) 324-0800

Fax

(215) 324-0801

NPI assigned

Jan 29, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Tracemark Pharmacy

  • Community/Retail Pharmacy
  • Philadelphia, PA
  • NPI 1215254305
  NPD (past) Authorized official

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264723200000",
    "number": "1356673487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4839 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191412107",
            "telephone_number": "215-324-0800",
            "fax_number": "215-324-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4839 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191412107",
            "telephone_number": "215-324-0800",
            "fax_number": "215-324-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANTERPOOL",
        "first_name": "BEVIS",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-29",
        "last_updated": "2010-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "PP481991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vantage Eyecare, LLC
• Vantage Eyecare, LLC
• Vantage Eyecare, LLC
• Vantage Eyecare, LLC
• Vantage Eyecare, LLC
• Kisha Vanterpool, MD
• Grace Vanthuyne, PA-C
• Skyla Imani Vantrikt, BS, CLD, CPD
• Sravya Gayatri Vanukuru, MD
• Daniel Scott Vanvolkenburgh, D.D.S.

• Pharmacist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.