Individual provider Active NPI

Bobby Vincent III, MS, PHARMD, RPH

  • Pharmacist
  • Manassas, VA
National Provider Identifier
1376312652
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202218258 Issued in VA
Practice address
8100 Albertstone Cir
Manassas, VA 20109-2537
Phone
(804) 218-8917
NPI assigned
Dec 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202218258 VA Primary

Addresses

Primary practice location

8100 Albertstone Cir
Manassas, VA 20109-2537

Mailing address

8100 Albertstone Cir
Manassas, VA 20109-2537
Phone (804) 218-8917

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
Master of Science, Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
0202218258VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1703635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1376312652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 ALBERTSTONE CIR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092537",
            "telephone_number": "804-218-8917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 ALBERTSTONE CIR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092537",
            "telephone_number": "804-218-8917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "BOBBY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MS, PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-27",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202218258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.