Individual provider Active NPI

Christine Tesack, RPH

  • Pharmacist
  • Charlottesville, VA
National Provider Identifier
1639456130
Registry record updated Nov 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202012196 Issued in VA
Practice address
3489 Seminole TRL
Charlottesville, VA 22911-5637
Phone
(434) 964-1082
Fax
(434) 964-1640
NPI assigned
Nov 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202012196 VA Primary

Addresses

Primary practice location

3489 Seminole TRL
Charlottesville, VA 22911-5637

Mailing address

3489 Seminole TRL
Charlottesville, VA 22911-5637
Phone (434) 964-1082

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
0202012196VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co 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": "1320969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320969600000",
    "number": "1639456130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3489 SEMINOLE TRL",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229115637",
            "telephone_number": "434-964-1082",
            "fax_number": "434-964-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3489 SEMINOLE TRL",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229115637",
            "telephone_number": "434-964-1082",
            "fax_number": "434-964-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESACK",
        "first_name": "CHRISTINE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-11",
        "last_updated": "2011-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202012196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2011; 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.