Active NPI
Nichodemus Elebeke, PHARM D
- Community/Retail Pharmacy
- Clinton, MD
National Provider Identifier
1366112187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 16449
- Practice address
- 8859 Branch Ave
Clinton, MD 20735-2632 - Phone
- (301) 868-4055
- NPI assigned
- Sep 14, 2021
- Last updated
- Sep 14, 2021
- 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 |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 16449 | MD | Primary |
Addresses
Primary practice location
8859 Branch Ave
Clinton, MD 20735-2632
Mailing address
8859 Branch Ave
Clinton, MD 20735-2632
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 |
|---|---|---|---|
| 16449 | MD | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1366112187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8859 BRANCH AVE",
"city": "CLINTON",
"state": "MD",
"postal_code": "207352632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8859 BRANCH AVE",
"city": "CLINTON",
"state": "MD",
"postal_code": "207352632",
"telephone_number": "301-868-4055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELEBEKE",
"first_name": "NICHODEMUS",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-09-14",
"last_updated": "2021-09-14",
"certification_date": "2021-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MD",
"license": "16449",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.