Individual provider Active NPI

Peter Kaldos

  • Pharmacist
  • Vienna, VA
National Provider Identifier
1851764781
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
23172 Issued in MD
Practice address
130 Patrick St SE
Vienna, VA 22180-6651
Phone
(347) 755-0567
NPI assigned
Oct 30, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 23172 MD Primary

Addresses

Primary practice location

130 Patrick St SE
Vienna, VA 22180-6651

Mailing address

130 Patrick St SE Apt 249
Vienna, VA 22180-6651
Phone (347) 755-0567

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

LicenseStateTypeSpecialty
23172MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1851764781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 PATRICK ST SE APT 249",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221806651",
            "telephone_number": "347-755-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 PATRICK ST SE",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221806651",
            "telephone_number": "347-755-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALDOS",
        "first_name": "PETER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-30",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "23172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.