Individual provider Active NPI

Luke Anthony Kubacki, PHARMD

  • Pharmacist
  • Wheeling, WV
National Provider Identifier
1477899136
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
WV0007970 Issued in WV
Practice address
842 National Rd
Wheeling, WV 26003-6439
Phone
(304) 232-3410
Fax
(304) 232-5116
NPI assigned
Dec 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X WV0007970 WV Primary
Pharmacist 183500000X RP446860 PA

Addresses

Primary practice location

842 National Rd
Wheeling, WV 26003-6439

Mailing address

842 National Rd
Wheeling, WV 26003-6439
Phone (304) 232-3410

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
RP446860PAMDPharmacist
WV0007970WVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia CVS Pharmacy LLC Past Accepting new patients
West Virginia CVS Pharmacy LLC 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": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1477899136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 NATIONAL RD",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036439",
            "telephone_number": "304-232-3410",
            "fax_number": "304-232-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 NATIONAL RD",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036439",
            "telephone_number": "304-232-3410",
            "fax_number": "304-232-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBACKI",
        "first_name": "LUKE",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-27",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "WV0007970",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP446860",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; 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.