Individual provider Active NPI

Bernard Roberts Jr., RPH, PHARMD

  • Pharmacist
  • Hamilton, OH
National Provider Identifier
1831646215
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03-2-17915 Issued in OH
Practice address
630 Eaton Ave
Hamilton, OH 45013-2767
Phone
(513) 867-2142
Fax
(513) 867-2141
NPI assigned
Sep 2, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03-2-17915 OH Primary

Addresses

Primary practice location

630 Eaton Ave
Hamilton, OH 45013-2767

Mailing address

630 Eaton Ave
Hamilton, OH 45013-2767
Phone (513) 867-2142

Other identifiers 1

IdentifierTypeStateIssuer
2875330MedicaidOH

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, Registered Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1472774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1831646215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 EATON AVE",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450132767",
            "telephone_number": "513-867-2142",
            "fax_number": "513-867-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 EATON AVE",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450132767",
            "telephone_number": "513-867-2142",
            "fax_number": "513-867-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "BERNARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "RPH, PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-02",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03-2-17915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2875330",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.