Wayne Clark Cheatum, R. PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS19080 Issued in FL

Practice address

2200 Bergquist Dr Suite 1
59 MDTS Pharmacy
Lackland AFB, TX 78236-9908

Phone

(210) 292-7216

Fax

(210) 292-3722

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407914146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13027 WILD HEART",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780233968",
            "telephone_number": "210-265-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR SUITE 1",
            "address_2": "59 MDTS PHARMACY",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-292-7216",
            "fax_number": "210-292-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEATUM",
        "first_name": "WAYNE",
        "middle_name": "CLARK",
        "name_prefix": "Mr.",
        "credential": "R. PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS19080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Marie Cervantes, RBT
• Patricia Escareno Cervantes, COA
• Lakisha Deshawnda Chaffin-Hickerson, OTR/L
• James Claud Chapman, O.D.
• Martha Daniel Chapman, PHARM D
• John D. Childs, PT, PHD, OCS, FAAOMP
• Craig J Christenson, D.P.M.
• Shanequia Deshawn Clemons
• Christianne Michelle Clifford, D.O.
• Herman Shermaine Clincy Jr., HEALH SERVICES TECH

• Pharmacist in Lackland AFB, TX
• Providers in Lackland AFB, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.