Active NPI
Rebecca Ann Graves, PHARMD
- Pharmacist
- Vista, CA
National Provider Identifier
1407088586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 66658
- Practice address
- 1751 University Dr
Vista, CA 92083-7775 - Phone
- (760) 208-6000
- Fax
- (760) 666-6297
- NPI assigned
- Aug 21, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2005030404 | MO | |
| Pharmacist | 183500000X | 052329-1 | NY | |
| Pharmacist | 183500000X | 66658 | CA | Primary |
Addresses
Primary practice location
1751 University Dr
Vista, CA 92083-7775
Mailing address
1751 University Dr
Vista, CA 92083-7775
Phone (760) 208-6000
Other practice location 1
307 6th Ave
New York, NY 10014-4403
Phone (212) 255-5054
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 |
|---|---|---|---|
| 66658 | CA | MD | Pharmacist |
| 2005030404 | MO | MD | Pharmacist |
| 052329-1 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients |
Organizations & group practices 1
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
- New York, NY
- NPI 1679677413
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607212800000",
"number": "1407088586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1751 UNIVERSITY DR",
"city": "VISTA",
"state": "CA",
"postal_code": "920837775",
"telephone_number": "760-208-6000",
"fax_number": "760-666-6297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1751 UNIVERSITY DR",
"city": "VISTA",
"state": "CA",
"postal_code": "920837775",
"telephone_number": "760-208-6000",
"fax_number": "760-666-6297"
}
],
"practiceLocations": [
{
"address_1": "307 6th Ave",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100144403",
"country_code": "US",
"telephone_number": "212-255-5054",
"fax_number": "212-242-9851",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRAVES",
"first_name": "REBECCA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-21",
"last_updated": "2020-12-06",
"certification_date": "2020-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2005030404",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "052329-1",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "66658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.