Active NPI
Gregory Stuart Keith, PHARMD
- Pharmacist
- Lodi, CA
National Provider Identifier
1689659856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH39476
- Practice address
- 2449 W Kettleman Lane
Lodi, CA 95242 - Phone
- (209) 367-7882
- Fax
- (209) 367-7886
- NPI assigned
- Dec 10, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH39476 | CA | Primary |
Addresses
Primary practice location
2449 W Kettleman Lane
Lodi, CA 95242
Mailing address
PO Box 1623
Woodbridge, CA 95258-1623
Phone (209) 334-4908
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH39476 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | 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": "1134172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288656000000",
"number": "1689659856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1623",
"city": "WOODBRIDGE",
"state": "CA",
"postal_code": "952581623",
"telephone_number": "209-334-4908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2449 W KETTLEMAN LANE",
"city": "LODI",
"state": "CA",
"postal_code": "95242",
"telephone_number": "209-367-7882",
"fax_number": "209-367-7886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEITH",
"first_name": "GREGORY",
"middle_name": "STUART",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-10",
"last_updated": "2010-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH39476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.