Active NPI
Thomas Paul Dadisman
- Pharmacist
- Philippi, WV
National Provider Identifier
1508079708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4985
- Practice address
- 303 S Main St
Philippi, WV 26416-1240 - Phone
- (304) 457-4233
- NPI assigned
- May 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4985 | WV | Primary |
Addresses
Primary practice location
303 S Main St
Philippi, WV 26416-1240
Mailing address
303 S Main St
Philippi, WV 26416-1240
Phone (304) 457-5207
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4985 | Other | WV | STATE LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4985 | WV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maces Pharmacy Inc | Past | 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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Belington, WV
- NPI 1770841637
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185753600000",
"number": "1508079708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 S MAIN ST",
"city": "PHILIPPI",
"state": "WV",
"postal_code": "264161240",
"telephone_number": "304-457-5207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 S MAIN ST",
"city": "PHILIPPI",
"state": "WV",
"postal_code": "264161240",
"telephone_number": "304-457-4233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DADISMAN",
"first_name": "THOMAS",
"middle_name": "PAUL",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "4985",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "4985",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philippi, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.