Active NPI
Derek David O'Neill
- Pharmacist
- Philadelphia, PA
National Provider Identifier
1780288746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP452350
- Practice address
- 4314 Locust St
Philadelphia, PA 19104-5232 - Phone
- (215) 386-2093
- Fax
- (215) 386-9804
- NPI assigned
- Nov 30, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | RP452350 | PA | Primary |
Addresses
Primary practice location
4314 Locust St
Philadelphia, PA 19104-5232
Mailing address
5040 Palmer Mill Rd
Clifton Heights, PA 19018-1008
Phone (610) 368-8105
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
| License | State | Type | Specialty |
|---|---|---|---|
| RP452350 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pennsylvania CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Pennsylvania CVS Pharmacy, L.L.C. | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1780288746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5040 PALMER MILL RD",
"city": "CLIFTON HEIGHTS",
"state": "PA",
"postal_code": "190181008",
"telephone_number": "610-368-8105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4314 LOCUST ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191045232",
"telephone_number": "215-386-2093",
"fax_number": "215-386-9804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'NEILL",
"first_name": "DEREK",
"middle_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-30",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP452350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.