Individual provider Active NPI

Patricia Wagner Slattum, PHARM.D., PH.D.

  • Geriatric Pharmacist
  • Richmond, VA
National Provider Identifier
1629138565
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric PharmacistTaxonomy code 1835G0303X
License
0202007537 Issued in VA
Practice address
410 N 12TH St
Smith RM 454, Box 980533
Richmond, VA 23298-5062
Phone
(804) 828-6355
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Pharmacist 1835G0303X 0202007537 VA Primary

Addresses

Primary practice location

410 N 12TH St
Smith RM 454, Box 980533
Richmond, VA 23298-5062

Mailing address

20870 Old Neck Rd
Charles City, VA 23030-4132
Phone (804) 829-6650

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 Philosophy, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
0202007537VAMDGeriatric Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629138565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20870 OLD NECK RD",
            "city": "CHARLES CITY",
            "state": "VA",
            "postal_code": "230304132",
            "telephone_number": "804-829-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N 12TH ST",
            "address_2": "SMITH RM 454, BOX 980533",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985062",
            "telephone_number": "804-828-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATTUM",
        "first_name": "PATRICIA",
        "middle_name": "WAGNER",
        "credential": "PHARM.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "VA",
            "license": "0202007537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

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

Verify at the official NPI Registry.