Individual provider Active NPI

Kevin Thomas Deane, RPH

  • Pharmacist
  • Walterboro, SC
National Provider Identifier
1396093274
Registry record updated Aug 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
SC8096 Issued in SC
Practice address
555 Robertson Blvd
Walterboro, SC 29488-2787
Phone
(843) 549-1546
Fax
(843) 549-9616
NPI assigned
Aug 26, 2012
Last updated
Aug 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X SC8096 SC Primary
Pharmacist 183500000X 022579 MI

Addresses

Primary practice location

555 Robertson Blvd
Walterboro, SC 29488-2787

Mailing address

555 Robertson Blvd
Walterboro, SC 29488-2787
Phone (843) 549-1546

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
022579MIMDPharmacist
SC8096SCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1345939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345939200000",
    "number": "1396093274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 ROBERTSON BLVD",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882787",
            "telephone_number": "843-549-1546",
            "fax_number": "843-549-9616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 ROBERTSON BLVD",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882787",
            "telephone_number": "843-549-1546",
            "fax_number": "843-549-9616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANE",
        "first_name": "KEVIN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-26",
        "last_updated": "2012-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "SC8096",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "022579",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walterboro, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2012; 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.