Individual provider Active NPI

Chris T Fetherolf

  • Pharmacy Technician
  • London, OH
National Provider Identifier
1770250417
Registry record updated Aug 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
2303-7848 Issued in OH
Practice address
375 Lafayette St
London, OH 43140-9326
Phone
(740) 852-2726
NPI assigned
Aug 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 2303-7848 OH Primary

Addresses

Primary practice location

375 Lafayette St
London, OH 43140-9326

Mailing address

375 Lafayette St
London, OH 43140-9326
Phone (740) 852-2726

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
2303-7848OHMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1630195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630195200000",
    "number": "1770250417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 LAFAYETTE ST",
            "city": "LONDON",
            "state": "OH",
            "postal_code": "431409326",
            "telephone_number": "740-852-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 LAFAYETTE ST",
            "city": "LONDON",
            "state": "OH",
            "postal_code": "431409326",
            "telephone_number": "740-852-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETHEROLF",
        "first_name": "CHRIS",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-29",
        "last_updated": "2021-08-29",
        "certification_date": "2021-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "OH",
            "license": "2303-7848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in London, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.