Active NPI
Robert Wagonblott
- Pharmacotherapy Pharmacist
- Reynoldsburg, OH
National Provider Identifier
1700296472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 03209278
- Practice address
- 8000 E Broad St
Reynoldsburg, OH 43068-8032 - Phone
- (614) 322-7433
- Fax
- (614) 322-7433
- NPI assigned
- May 5, 2014
- Last updated
- May 5, 2014
- 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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 03209278 | OH | Primary |
Addresses
Primary practice location
8000 E Broad St
Reynoldsburg, OH 43068-8032
Mailing address
7749 Burkey Dr
8000 E Broad Street
Reynoldsburg, OH 43068-2619
Phone (614) 322-7433
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 |
|---|---|---|---|
| 03209278 | OH | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399248000000",
"number": "1700296472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7749 BURKEY DR",
"address_2": "8000 E BROAD STREET",
"city": "REYNOLDSBURG",
"state": "OH",
"postal_code": "430682619",
"telephone_number": "614-322-7433",
"fax_number": "614-322-7465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8000 E BROAD ST",
"city": "REYNOLDSBURG",
"state": "OH",
"postal_code": "430688032",
"telephone_number": "614-322-7433",
"fax_number": "614-322-7433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGONBLOTT",
"first_name": "ROBERT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-05",
"last_updated": "2014-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "OH",
"license": "03209278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reynoldsburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.