Individual provider Active NPI

Charles J Fritz, RPH

  • Pharmacist
  • Carlinville, IL
National Provider Identifier
1881868198
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
Practice address
494 W Side SQ
Carlinville, IL 62626-1753
Phone
(217) 854-4022
Fax
(217) 854-4300
NPI assigned
Apr 17, 2008
Last updated
Apr 17, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X IL Primary

Addresses

Primary practice location

494 W Side SQ
Carlinville, IL 62626-1753

Mailing address

494 W Side SQ
Carlinville, IL 62626-1753
Phone (217) 854-4022

Other identifiers 1

IdentifierTypeStateIssuer
261337649001MedicaidIL

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

LicenseStateTypeSpecialty
051026539ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1881868198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "494 W SIDE SQ",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "626261753",
            "telephone_number": "217-854-4022",
            "fax_number": "217-854-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "494 W SIDE SQ",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "626261753",
            "telephone_number": "217-854-4022",
            "fax_number": "217-854-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRITZ",
        "first_name": "CHARLES",
        "middle_name": "J",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261337649001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlinville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.