Individual provider Active NPI

Deron Thomas Lundy, PHARMD, R.PH.

  • Pharmacist
  • Columbus, OH
National Provider Identifier
1861708299
Registry record updated Aug 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03230641-2 Issued in OH
Practice address
111 S Grant Ave
Department of Pharmacy Services
Columbus, OH 43215-4701
Phone
(614) 566-9053
Fax
(614) 566-8337
NPI assigned
Aug 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03230641-2 OH Primary

Addresses

Primary practice location

111 S Grant Ave
Department of Pharmacy Services
Columbus, OH 43215-4701

Mailing address

1120 Waterford Pointe Cir
Columbus, OH 43228-9102
Phone (614) 335-5755

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

State licenses

LicenseStateTypeSpecialty
03230641-2OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282521600000",
    "number": "1861708299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 WATERFORD POINTE CIR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432289102",
            "telephone_number": "614-335-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S GRANT AVE",
            "address_2": "DEPARTMENT OF PHARMACY SERVICES",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154701",
            "telephone_number": "614-566-9053",
            "fax_number": "614-566-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDY",
        "first_name": "DERON",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PHARMD, R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-23",
        "last_updated": "2010-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03230641-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.

Verify at the official NPI Registry.