Individual provider Active NPI

Christopher Gomez

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Mayaguez, PR
National Provider Identifier
1871860494
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
12225-40 Issued in WI
Practice address
175 Ave Algarrobo
Mayaguez, PR 00682-6331
Phone
(939) 227-4858
NPI assigned
Nov 28, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 12225-40 WI
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 12225-40 WI Primary

Addresses

Primary practice location

175 Ave Algarrobo
Mayaguez, PR 00682-6331

Mailing address

3710 E Washington Ave
Madison, WI 53704-3647
Phone (608) 242-9483

Other practice location 1

3710 E Washington Ave
Madison, WI 53704-3647
Phone (608) 242-9483

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
12225-40WIMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1871860494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537043647",
            "telephone_number": "608-242-9483",
            "fax_number": "608-242-9554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 AVE ALGARROBO",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006826331",
            "telephone_number": "939-227-4858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3710 E Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537043647",
            "country_code": "US",
            "telephone_number": "608-242-9483",
            "fax_number": "608-242-9554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-28",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "12225-40",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WI",
            "license": "12225-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.