Individual provider Active NPI

Scott J Garvin, PHARMD

  • Pharmacist
  • Bartonville, IL
National Provider Identifier
1467057117
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051303422 Issued in IL
Practice address
1008 W Garfield Ave
Bartonville, IL 61607-1851
Phone
(309) 697-8122
NPI assigned
Dec 1, 2020
Last updated
Dec 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051303422 IL Primary

Addresses

Primary practice location

1008 W Garfield Ave
Bartonville, IL 61607-1851

Mailing address

5400 W Sienna LN Apt 6209
Peoria, IL 61615-7869
Phone (309) 714-0333

Other practice location 1

5400 W Sienna Ln Apt 6209
Peoria, IL 61615-7869
Phone (309) 714-0333

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

LicenseStateTypeSpecialty
051303422ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Park CVS, L.L.C. PastSince Dec 6, 2020 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1467057117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 W SIENNA LN APT 6209",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157869",
            "telephone_number": "309-714-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 W GARFIELD AVE",
            "city": "BARTONVILLE",
            "state": "IL",
            "postal_code": "616071851",
            "telephone_number": "309-697-8122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5400 W Sienna Ln Apt 6209",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616157869",
            "country_code": "US",
            "telephone_number": "309-714-0333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARVIN",
        "first_name": "SCOTT",
        "middle_name": "J",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051303422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartonville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.

Verify at the official NPI Registry.