Individual provider Active NPI

Patrick Jason Tracey Jr., PHARM. D.

  • Pharmacist
  • Coventry, RI
National Provider Identifier
1487372892
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH06428 Issued in RI
Practice address
763 Tiogue Ave
Coventry, RI 02816-5805
Phone
(401) 821-2060
NPI assigned
Aug 22, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH06428 RI Primary

Addresses

Primary practice location

763 Tiogue Ave
Coventry, RI 02816-5805

Mailing address

763 Tiogue Ave
Coventry, RI 02816-5805
Phone (401) 821-2060

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
RPH06428RIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island CVS Pharmacy LLC PastSince Aug 28, 2022 Accepting new patients
Rhode Island CVS Pharmacy, L.L.C. PastSince Aug 28, 2022 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": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1487372892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 TIOGUE AVE",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028165805",
            "telephone_number": "401-821-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 TIOGUE AVE",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028165805",
            "telephone_number": "401-821-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACEY",
        "first_name": "PATRICK",
        "middle_name": "JASON",
        "name_suffix": "Jr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "RI",
            "license": "RPH06428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coventry, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.