Active NPI
Robert Edward Newberry Jr., PHARM.D.
- Pharmacy
- Princeton, WV
National Provider Identifier
1427712702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- RP0012717
- Practice address
- 1229 Stafford Dr
Princeton, WV 24740-2465 - Phone
- (304) 487-1155
- NPI assigned
- Oct 23, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacy | 333600000X | RP0012717 | WV | Primary |
Addresses
Primary practice location
1229 Stafford Dr
Princeton, WV 24740-2465
Mailing address
PO Box 481
Roderfield, WV 24881-0481
Phone (304) 938-6141
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 |
|---|---|---|---|
| RP0012717 | WV | MD | Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Limited Partnership I | 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.
-
- Community/Retail Pharmacy
- Newport, KY
- NPI 1104791078
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634947200000",
"number": "1427712702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 481",
"city": "RODERFIELD",
"state": "WV",
"postal_code": "248810481",
"telephone_number": "304-938-6141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1229 STAFFORD DR",
"city": "PRINCETON",
"state": "WV",
"postal_code": "247402465",
"telephone_number": "304-487-1155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWBERRY",
"first_name": "ROBERT",
"middle_name": "EDWARD",
"name_suffix": "Jr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-10-23",
"last_updated": "2021-10-23",
"certification_date": "2021-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "WV",
"license": "RP0012717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Princeton, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.