Individual provider Active NPI

Christina Procaccianti, PHARMD

  • Pharmacist
  • Wakefield, RI
National Provider Identifier
1609042407
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH04801 Issued in RI
Practice address
203 Main St
Wakefield, RI 02879-3557
Phone
(401) 307-2555
Fax
(401) 783-0045
NPI assigned
May 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PCT.0011261 CT
Pharmacist 183500000X RPH04801 RI Primary
Pharmacist 183500000X 27125 MA

Addresses

Primary practice location

203 Main St
Wakefield, RI 02879-3557

Mailing address

245 Main St
Wakefield, RI 02879-3527

Other names 1

  • Miss Christina Passalacqua Former name

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
PCT.0011261CTMDPharmacist
27125MAMDPharmacist
RPH04801RIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Green Line Apothecary LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1609042407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 MAIN ST",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028793527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 MAIN ST",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028793557",
            "telephone_number": "401-307-2555",
            "fax_number": "401-783-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCACCIANTI",
        "first_name": "CHRISTINA",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-01",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0011261",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "RI",
            "license": "RPH04801",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "27125",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "PASSALACQUA",
            "prefix": "MISS",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wakefield, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.