Individual provider Active NPI

Rosemary Larussa Conkel, RPH

  • Pharmacist
  • Loxahatchee, FL
National Provider Identifier
1750667374
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS23701 Issued in FL
Practice address
15940 Orange Blvd
Loxahatchee, FL 33470-3442
Phone
(561) 899-1379
NPI assigned
Oct 27, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS23701 FL Primary

Addresses

Primary practice location

15940 Orange Blvd
Loxahatchee, FL 33470-3442

Mailing address

15363 77TH PL N
Loxahatchee, FL 33470-3159
Phone (561) 792-1362

Other names 1

  • Rosemary Larussa Gomez Former name

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
PS23701FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co PastSince Apr 17, 2022 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": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1750667374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15363 77TH PL N",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334703159",
            "telephone_number": "561-792-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15940 ORANGE BLVD",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334703442",
            "telephone_number": "561-899-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARUSSA CONKEL",
        "first_name": "ROSEMARY",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-27",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS23701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSEMARY",
            "last_name": "LARUSSA GOMEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Loxahatchee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.