Gregory Spake, RPH. CPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS25626 Issued in FL

Practice address

4020 N Wickham Rd
Melbourne, FL 32935-2472

Phone

(321) 254-7803

Fax

(321) 449-0585

NPI assigned

Sep 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Melbourne, FL
  • NPI 1093722084
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649372186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 156",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329230156",
            "fax_number": "321-449-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352472",
            "telephone_number": "321-254-7803",
            "fax_number": "321-449-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAKE",
        "first_name": "GREGORY",
        "name_prefix": "Mr.",
        "credential": "RPH. CPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS25626",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PU5073",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "9383",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Space Coast Therapy and Wellness
• Space Coast Vascular Inc
• Spacecoastpop LLC
• Spacecoastpop LLC
• David Louis Spadaccini, RPH
• Steven Spake, RBT
• Cameron Spanogle, PA-C
• Adam Richard Spanovich, D.C
• Leah Henrietta Sparacino
• Jessica H Sparling, M.S, BCBA

• Pharmacist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Pharmacist in Florida

• 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.