Individual provider Active NPI

Vickers Vincent Dsilva, RPH

  • Pharmacist
  • Virginia Beach, VA
National Provider Identifier
1902407612
Registry record updated Nov 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202207362 Issued in VA
Practice address
1832 Kempsville Rd
Virginia Beach, VA 23464-6861
Phone
(757) 278-2573
Fax
(757) 278-2567
NPI assigned
Nov 8, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 183500000X 0202207362 VA Primary

Addresses

Primary practice location

1832 Kempsville Rd
Virginia Beach, VA 23464-6861

Mailing address

953 Elliott Rd
Virginia Beach, VA 23464-1798
Phone (423) 202-0534

Other identifiers 1

IdentifierTypeStateIssuer
4845561OtherVASTORE NCPDP NUMBER

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
0202207362VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1604793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604793600000",
    "number": "1902407612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "953 ELLIOTT RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234641798",
            "telephone_number": "423-202-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1832 KEMPSVILLE RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234646861",
            "telephone_number": "757-278-2573",
            "fax_number": "757-278-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DSILVA",
        "first_name": "VICKERS",
        "middle_name": "VINCENT",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-08",
        "last_updated": "2020-11-08",
        "certification_date": "2020-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202207362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STORE NCPDP NUMBER",
            "identifier": "4845561",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.