Individual provider Active NPI

William Joseph Scully III, RPH

  • Pharmacist
  • Mason, OH
National Provider Identifier
1649307166
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03232617 Issued in OH
Practice address
4830 Bridge LN Apt 3
Mason, OH 45040-7040
Phone
(859) 572-0123
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03232617 OH Primary

Addresses

Primary practice location

4830 Bridge LN Apt 3
Mason, OH 45040-7040

Mailing address

4830 Bridge LN Apt 3
Mason, OH 45040-7040
Phone (859) 992-8794

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
03232617OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1649307166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4830 BRIDGE LN APT 3",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450407040",
            "telephone_number": "859-992-8794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4830 BRIDGE LN APT 3",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450407040",
            "telephone_number": "859-572-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULLY",
        "first_name": "WILLIAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03232617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; 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.