NPIMap

Individual provider Active NPI

Michael Libonate, PHARMD

  • Pharmacist
  • Pottsville, PA
National Provider Identifier
1922398031
Registry record updated Apr 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP439569 Issued in PA
Practice address
500 N Claude a Lord Blvd
Pottsville, PA 17901-3868
Phone
(570) 622-2224
NPI assigned
Apr 10, 2011
Last updated
Apr 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP439569 PA Primary

Addresses

Primary practice location

500 N Claude a Lord Blvd
Pottsville, PA 17901-3868

Mailing address

500 N Claude a Lord Blvd
Pottsville, PA 17901-3868
Phone (570) 622-2224

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

State licenses

LicenseStateTypeSpecialty
RP439569PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Pennsylvania LLC Past Accepting new patients
Rite Aid of Pennsylvania LLC Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1302393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302393600000",
    "number": "1922398031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N CLAUDE A LORD BLVD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013868",
            "telephone_number": "570-622-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N CLAUDE A LORD BLVD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013868",
            "telephone_number": "570-622-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBONATE",
        "first_name": "MICHAEL",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-10",
        "last_updated": "2011-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP439569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2011; 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.