Individual provider Active NPI

Daniel Joseph Ketchum, RPH

  • Pharmacist
  • Carmichael, CA
National Provider Identifier
1649516428
Registry record updated Dec 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
33070 Issued in CA
Practice address
6501 Coyle Ave
Carmichael, CA 95608-0306
Phone
(916) 537-5420
NPI assigned
Dec 22, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 33070 CA Primary

Addresses

Primary practice location

6501 Coyle Ave
Carmichael, CA 95608-0306

Mailing address

2072 Devonport Loop
Roseville, CA 95747-8829
Phone (916) 945-7201

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

NPI Registry JSON

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

{
    "created_epoch": "1356134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356134400000",
    "number": "1649516428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2072 DEVONPORT LOOP",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957478829",
            "telephone_number": "916-945-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 COYLE AVE",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080306",
            "telephone_number": "916-537-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-22",
        "last_updated": "2012-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "33070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2012; 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.