Individual provider Active NPI

Jatin Kirtikumar Mehta, RPH

  • Pharmacist
  • Antioch, CA
National Provider Identifier
1649582305
Registry record updated Jul 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
61011 Issued in CA
Practice address
4100 Lone Tree Way
Antioch, CA 94531-6201
Phone
(925) 522-0150
Fax
(925) 522-0155
NPI assigned
Jul 10, 2010
Last updated
Jul 10, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 61011 CA Primary

Addresses

Primary practice location

4100 Lone Tree Way
Antioch, CA 94531-6201

Mailing address

1307 Carlisle CT
Brentwood, CA 94513-1761
Phone (925) 516-9068

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
61011CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Medical Pharmacy Antioch CurrentSince Jan 26, 2020 Accepting new patients
Delta Medical Pharmacy Antioch Current Accepting new patients
Thrifty Payless, Inc. Past Accepting new patients
Thrifty Payless Inc Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278720000000",
    "number": "1649582305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 CARLISLE CT",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945131761",
            "telephone_number": "925-516-9068",
            "fax_number": "925-522-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LONE TREE WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945316201",
            "telephone_number": "925-522-0150",
            "fax_number": "925-522-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "JATIN",
        "middle_name": "KIRTIKUMAR",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-10",
        "last_updated": "2010-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "61011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2010; 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.