Active NPI
Kevin Thomas Deane, RPH
- Pharmacist
- Walterboro, SC
National Provider Identifier
1396093274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- SC8096
- 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, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 022579 | MI | MD | Pharmacist |
| SC8096 | SC | MD | Pharmacist |
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.