Individual provider Active NPI

Jeff Daniel Derouchey, PHARM D

  • Pharmacist
  • Sioux Falls, SD
National Provider Identifier
1952485328
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5378 Issued in SD
Practice address
3209 S Louise Ave
Sioux Falls, SD 57106-0704
Phone
(605) 362-1602
Fax
(605) 361-3476
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5378 SD Primary

Addresses

Primary practice location

3209 S Louise Ave
Sioux Falls, SD 57106-0704

Mailing address

5115 Rolling Green Ave Apt 308
Sioux Falls, SD 57108-2218
Phone (605) 271-1181

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
5378SDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952485328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 ROLLING GREEN AVE APT 308",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082218",
            "telephone_number": "605-271-1181",
            "fax_number": "605-361-3476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 S LOUISE AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571060704",
            "telephone_number": "605-362-1602",
            "fax_number": "605-361-3476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROUCHEY",
        "first_name": "JEFF",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SD",
            "license": "5378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.