Individual provider Active NPI

Gene Pelikhov, PHARMD

  • Pharmacist
  • Swampscott, MA
National Provider Identifier
1487922043
Registry record updated Oct 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
233084 Issued in MA
Practice address
413 Paradise Rd
Swampscott, MA 01907-1332
Phone
(781) 595-8588
NPI assigned
Dec 9, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 233084 MA Primary

Addresses

Primary practice location

413 Paradise Rd
Swampscott, MA 01907-1332

Mailing address

413 Paradise Rd
Swampscott, MA 01907-1332

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
233084MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477699200000",
    "number": "1487922043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 PARADISE RD",
            "city": "SWAMPSCOTT",
            "state": "MA",
            "postal_code": "019071332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 PARADISE RD",
            "city": "SWAMPSCOTT",
            "state": "MA",
            "postal_code": "019071332",
            "telephone_number": "781-595-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELIKHOV",
        "first_name": "GENE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-09",
        "last_updated": "2016-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "233084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swampscott, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.