Individual provider Active NPI

Jonathan Chan, RPH

  • Pharmacist
  • Chelmsford, MA
National Provider Identifier
1679178479
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH26578 Issued in MA
Practice address
66-2 Drum Hill Shopping Center
Chelmsford, MA 01824
Phone
(978) 970-2001
NPI assigned
Dec 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH26578 MA Primary

Addresses

Primary practice location

66-2 Drum Hill Shopping Center
Chelmsford, MA 01824

Mailing address

66-2 Drum Hill Shopping Center
Chelmsford, MA 01824
Phone (978) 970-2001

Other practice location 1

66-2 Drum Hill Shopping Center
Chelmsford, MA 01960
Phone (978) 970-2001

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
PH26578MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Victory Distributors LLC PastSince Dec 6, 2020 Accepting new patients
Victory Distributors, LLC PastSince Dec 6, 2020 Accepting new patients

Organizations & group practices 2

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": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1679178479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66-2 DRUM HILL SHOPPING CENTER",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "01824",
            "telephone_number": "978-970-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66-2 DRUM HILL SHOPPING CENTER",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "01824",
            "telephone_number": "978-970-2001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "66-2 Drum Hill Shopping Center",
            "address_purpose": "LOCATION",
            "city": "Chelmsford",
            "state": "MA",
            "postal_code": "01960",
            "country_code": "US",
            "telephone_number": "978-970-2001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JONATHAN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH26578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelmsford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.