Active NPI
David Procaccini, PHARMD
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Baltimore, MD
National Provider Identifier
1629517511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 20113
- Practice address
- 1800 Orleans St RM 4362
Baltimore, MD 21287-0010 - Phone
- (410) 502-6458
- NPI assigned
- Feb 13, 2017
- Last updated
- Feb 13, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 20113 | MD | Primary |
Addresses
Primary practice location
1800 Orleans St RM 4362
Baltimore, MD 21287-0010
Mailing address
715 S Potomac St
Baltimore, MD 21224-3956
Phone (609) 937-6202
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
| License | State | Type | Specialty |
|---|---|---|---|
| 20113 | MD | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486944000000",
"number": "1629517511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 S POTOMAC ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212243956",
"telephone_number": "609-937-6202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 ORLEANS ST RM 4362",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212870010",
"telephone_number": "410-502-6458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCACCINI",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-13",
"last_updated": "2017-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "MD",
"license": "20113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
- PRN Solutions LLC
- Proactive Behavioral Health Services LLC
- Proactive Therapy, LLC
- John Calvin Probasco, MD
- Probity Health Inc
- Lauren Procaccini, CRNA
- Procare Pharmacy LLC (CarePlus CVS/pharmacy #2917)
- Procare Pharmacy Monument Street LLC (Pharmacare Specialty Pharmacy)
- Erica Constance Prochaska, MD
- Delisa Procks, PH. D
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.