Individual provider Active NPI

Dacia Grant, RPH

  • Pharmacist
  • Bronx, NY
National Provider Identifier
1962708594
Registry record updated Jan 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT.0011175 Issued in CT
Practice address
1998 Bruckner Blvd
Bronx, NY 10473-2500
Phone
(718) 430-9513
Fax
(718) 430-1589
NPI assigned
Jan 30, 2011
Last updated
Jan 30, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 055397-1 NY
Pharmacist 183500000X PCT.0011175 CT Primary

Addresses

Primary practice location

1998 Bruckner Blvd
Bronx, NY 10473-2500

Mailing address

1998 Bruckner Blvd
Bronx, NY 10473-2500
Phone (718) 430-9513

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
PCT.0011175CTMDPharmacist
055397-1NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1296345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296345600000",
    "number": "1962708594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1998 BRUCKNER BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104732500",
            "telephone_number": "718-430-9513",
            "fax_number": "718-430-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1998 BRUCKNER BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104732500",
            "telephone_number": "718-430-9513",
            "fax_number": "718-430-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "DACIA",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-30",
        "last_updated": "2011-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "055397-1",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0011175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.