Active NPI
Rachelle Dickerson, R.PH.
- Pharmacist
- Parkersburg, WV
National Provider Identifier
1851694111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5781
- Practice address
- 2007 7TH St
Parkersburg, WV 26101-3801 - Phone
- (304) 428-4705
- Fax
- (304) 424-6643
- NPI assigned
- Dec 8, 2010
- Last updated
- Dec 8, 2010
- 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 | 5781 | WV | Primary |
Addresses
Primary practice location
2007 7TH St
Parkersburg, WV 26101-3801
Mailing address
2007 7TH St
Parkersburg, WV 26101-3801
Phone (304) 428-4705
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 |
|---|---|---|---|
| 5781 | WV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Limited Partnership I | Past | Accepting new patients | |
| Kroger Limited Partnership I | 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.
-
dba Kroger Pharmacy
- Community/Retail Pharmacy
- Parkersburg, WV
- NPI 1790700490
-
dba Kroger Pharmacy #473
- Community/Retail Pharmacy
- Newport, KY
- NPI 1104791078
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291766400000",
"number": "1851694111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2007 7TH ST",
"city": "PARKERSBURG",
"state": "WV",
"postal_code": "261013801",
"telephone_number": "304-428-4705",
"fax_number": "304-424-6643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2007 7TH ST",
"city": "PARKERSBURG",
"state": "WV",
"postal_code": "261013801",
"telephone_number": "304-428-4705",
"fax_number": "304-424-6643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "RACHELLE",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-08",
"last_updated": "2010-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "5781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Parkersburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.