Individual provider Active NPI

Kostantinos Michael Katsanevakis, PHARMD

  • Pharmacist
  • Charleston, SC
National Provider Identifier
1821340381
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13700 Issued in SC
Practice address
150 Ashley Ave
MSC 584
Charleston, SC 29425-8907
Phone
(843) 876-5585
NPI assigned
Oct 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13700 SC Primary

Addresses

Primary practice location

150 Ashley Ave
MSC 584
Charleston, SC 29425-8907

Mailing address

150 Ashley Ave.
MSC 584
Charleston, SC 29425
Phone (843) 876-5585

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
13700SCMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1821340381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 ASHLEY AVE.",
            "address_2": "MSC 584",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425",
            "telephone_number": "843-876-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 ASHLEY AVE",
            "address_2": "MSC 584",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258907",
            "telephone_number": "843-876-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATSANEVAKIS",
        "first_name": "KOSTANTINOS",
        "middle_name": "MICHAEL",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-09",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "13700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.