Active NPI
Wilde Francesca Ketchatang, PHARMD
- Pharmacist
- Annapolis, MD
National Provider Identifier
1396349155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26408
- Practice address
- 2601 Riva Rd
Annapolis, MD 21401-7304 - Phone
- (443) 897-4752
- NPI assigned
- Nov 23, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26408 | MD | Primary |
Addresses
Primary practice location
2601 Riva Rd
Annapolis, MD 21401-7304
Mailing address
904 Bittersweet Rd
Pikesville, MD 21208-3543
Phone (443) 897-4752
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 |
|---|---|---|---|
| 26408 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606089600000",
"number": "1396349155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "904 BITTERSWEET RD",
"city": "PIKESVILLE",
"state": "MD",
"postal_code": "212083543",
"telephone_number": "443-897-4752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 RIVA RD",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214017304",
"telephone_number": "443-897-4752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETCHATANG",
"first_name": "WILDE",
"middle_name": "FRANCESCA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-23",
"last_updated": "2020-11-23",
"certification_date": "2020-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "26408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Annapolis, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.