Active NPI
Chidubem Ifeji
- Pharmacotherapy Pharmacist
- Danville, PA
National Provider Identifier
1679257943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- P458054
- Practice address
- 100 N Academy Ave
Danville, PA 17822-9800 - Phone
- (570) 271-5594
- NPI assigned
- Jun 14, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pharmacist | 183500000X | RP458054 | PA | |
| Pharmacotherapy Pharmacist | 1835P1200X | P458054 | PA | Primary |
Addresses
Primary practice location
100 N Academy Ave
Danville, PA 17822-9800
Mailing address
100 N Academy Ave
Danville, PA 17822-9800
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP458054 | PA | MD | Pharmacist |
| P458054 | PA | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711843200000",
"number": "1679257943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178229800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178229800",
"telephone_number": "570-271-5594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IFEJI",
"first_name": "CHIDUBEM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-14",
"last_updated": "2024-03-31",
"certification_date": "2024-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP458054",
"primary": false
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "PA",
"license": "P458054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.