Felix F. Etebom, BS BSPHARM

Primary specialty

PharmacistTaxonomy code 183500000X

License

13780 Issued in MD

Practice address

13202 Steeplechase Dr
Bowie, MD 20715-4542

Phone

(301) 352-2514

Fax

(301) 805-0664

NPI assigned

Jun 3, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: felixetebom@ppspllc.kareodirect.com

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.

• Pharmacy & Pharmaceutical Services Provider

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Bowie, MD
  • NPI 1619378890
  NPD Authorized official

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1376863183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13202 STEEPLECHASE DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154542",
            "telephone_number": "301-352-2514",
            "fax_number": "301-805-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13202 STEEPLECHASE DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154542",
            "telephone_number": "301-352-2514",
            "fax_number": "301-805-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETEBOM",
        "first_name": "FELIX",
        "middle_name": "F.",
        "name_prefix": "Mr.",
        "credential": "BS BSPHARM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-03",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835N1003X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nutrition Support",
            "state": "MD",
            "license": "13780",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MD",
            "license": "13780",
            "primary": false
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "MD",
            "license": "13780",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MD",
            "license": "13780",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "13780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APHA-NATIONAL CERTIFICATE PROGRAM FOR PHARMACIST  COMPREHENSIVE IMMUNIZATION .",
            "identifier": "CPN # 202-0014",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY & PHARMACEUTICAL SERVICES PROVIDER (PPSP)",
            "identifier": "PPSP LLC",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HTTP://WWW.PHARMACYPHARMACEUTICALSERVICES.COM",
            "identifier": "URL",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy E. Espy-Smith, MD
• Esteemed Families, LLC
• Alice Asong Esunge
• Et Home Health Agency
• Judith Timbui Eta
• Ethelaura Care Clinics LLC
• Ethelaura Care Clinics LLC
• Alemawung Abondem Etiendem
• Lerahzoah Etiendem
• Valentine B Etiendem

• Pharmacist in Bowie, MD
• Providers in Bowie, MD by specialty
• Pharmacist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.