Individual provider Active NPI

David Vanvalkenburgh, RPH

  • Pharmacist
  • Chicopee, MA
National Provider Identifier
1710608922
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH239968 Issued in MA
Practice address
1616 Memorial Dr
Chicopee, MA 01020-3933
Phone
(413) 532-3299
NPI assigned
Sep 6, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH239968 MA Primary

Addresses

Primary practice location

1616 Memorial Dr
Chicopee, MA 01020-3933

Mailing address

1616 Memorial Dr
Chicopee, MA 01020-3933
Phone (413) 532-3299

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
PH239968MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1710608922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 MEMORIAL DR",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010203933",
            "telephone_number": "413-532-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 MEMORIAL DR",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010203933",
            "telephone_number": "413-532-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANVALKENBURGH",
        "first_name": "DAVID",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH239968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicopee, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.