Individual provider Active NPI

Peter James Peplos

  • Pharmacist
  • Rockford, IL
National Provider Identifier
1750663050
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051039702 Issued in IL
Practice address
6622 Rolling Hedge LN
Rockford, IL 61108-5625
Phone
(815) 227-0819
NPI assigned
Sep 13, 2011
Last updated
Sep 13, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051039702 IL Primary

Addresses

Primary practice location

6622 Rolling Hedge LN
Rockford, IL 61108-5625

Mailing address

6622 Rolling Hedge LN
Rockford, IL 61108-5625
Phone (815) 227-0819

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

LicenseStateTypeSpecialty
051039702ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1750663050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6622 ROLLING HEDGE LN",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611085625",
            "telephone_number": "815-227-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6622 ROLLING HEDGE LN",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611085625",
            "telephone_number": "815-227-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPLOS",
        "first_name": "PETER",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051039702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.