Individual provider Active NPI

Raymond Kraucunas, RPH

  • Pharmacist
  • Elkhart, IN
National Provider Identifier
1457743585
Registry record updated Feb 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26019788A Issued in IN
Practice address
102 E Hively Ave.
Elkhart, IN 46517
Phone
(574) 522-2197
Fax
(574) 522-9352
NPI assigned
Feb 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26019788A IN Primary

Addresses

Primary practice location

102 E Hively Ave.
Elkhart, IN 46517

Mailing address

102 E Hively Ave.
Walgreens
Elkhart, IN 46517
Phone (574) 522-2197

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

LicenseStateTypeSpecialty
26019788AINMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Mar 27, 2022 Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1457743585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E HIVELY AVE.",
            "address_2": "WALGREENS",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "46517",
            "telephone_number": "574-522-2197",
            "fax_number": "574-522-9352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E HIVELY AVE.",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "46517",
            "telephone_number": "574-522-2197",
            "fax_number": "574-522-9352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUCUNAS",
        "first_name": "RAYMOND",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-26",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26019788A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.