Active NPI
Theresa Fairfax, RPH
- Pharmacist
- Seaside Heights, NJ
National Provider Identifier
1801492285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI02788100
- Practice address
- 1600RT 35 N
Seaside Heights, NJ 08751 - Phone
- (793) 793-2890
- NPI assigned
- Dec 10, 2020
- Last updated
- Dec 10, 2020
- Sex
- Female
- 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 | 28RI02788100 | NJ | Primary |
Addresses
Primary practice location
1600RT 35 N
Seaside Heights, NJ 08751
Mailing address
1600 RT 35 N
Seaside Heights, NJ 08751
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497850721 | Other | NPI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Theresa.Fairfax@cvshealth.com | New Jersey CVS Pharmacy LLC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI02788100 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Jersey CVS Pharmacy LLC | Past | Accepting new patients | |
| New Jersey CVS Pharmacy LLC | 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": "1607558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607558400000",
"number": "1801492285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 RT 35 N",
"city": "SEASIDE HEIGHTS",
"state": "NJ",
"postal_code": "08751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600RT 35 N",
"city": "SEASIDE HEIGHTS",
"state": "NJ",
"postal_code": "08751",
"telephone_number": "793-793-2890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRFAX",
"first_name": "THERESA",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-10",
"last_updated": "2020-12-10",
"certification_date": "2020-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI02788100",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1497850721",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Theresa.Fairfax@cvshealth.com",
"affiliation": "Y",
"affiliationName": "New Jersey CVS Pharmacy LLC",
"address_1": "1600 RT 35 N",
"city": "SEASIDE HEIGHTS",
"state": "NJ",
"country_code": "US",
"postal_code": "08751",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Seaside Heights, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.