Active NPI
Derek Engebretson, PHARMD
- Pharmacist
- Sparks, NV
National Provider Identifier
1730580119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18812
- Practice address
- 2299 Oddie Blvd
Sparks, NV 89431-7573 - Phone
- (775) 358-4721
- NPI assigned
- Sep 4, 2014
- Last updated
- Sep 4, 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18812 | NV | Primary |
Addresses
Primary practice location
2299 Oddie Blvd
Sparks, NV 89431-7573
Mailing address
2167 Lucca LN
Sparks, NV 89434-2053
Phone (775) 830-8144
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 |
|---|---|---|---|
| 18812 | NV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409788800000",
"number": "1730580119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2167 LUCCA LN",
"city": "SPARKS",
"state": "NV",
"postal_code": "894342053",
"telephone_number": "775-830-8144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2299 ODDIE BLVD",
"city": "SPARKS",
"state": "NV",
"postal_code": "894317573",
"telephone_number": "775-358-4721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGEBRETSON",
"first_name": "DEREK",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-04",
"last_updated": "2014-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "18812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sparks, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.