NPIMap

Individual provider Active NPI

Mary Christine Keglovits

  • Pharmacist
  • Smethport, PA
National Provider Identifier
1871117903
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP038900L Issued in PA
Practice address
313 W Main St
Smethport, PA 16749-1139
Phone
(814) 887-5375
Fax
(814) 887-5393
NPI assigned
Jun 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP038900L PA Primary

Addresses

Primary practice location

313 W Main St
Smethport, PA 16749-1139

Mailing address

313 W Main St
Smethport, PA 16749-1139
Phone (814) 887-5375

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
RP038900LPAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Buchanan Brothers Pharmacy Inc PastSince Jun 7, 2020 Accepting new patients
Novapharm Enterprises Inc. PastSince Jun 7, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1871117903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 W MAIN ST",
            "city": "SMETHPORT",
            "state": "PA",
            "postal_code": "167491139",
            "telephone_number": "814-887-5375",
            "fax_number": "814-887-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 W MAIN ST",
            "city": "SMETHPORT",
            "state": "PA",
            "postal_code": "167491139",
            "telephone_number": "814-887-5375",
            "fax_number": "814-887-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEGLOVITS",
        "first_name": "MARY",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP038900L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smethport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; 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.