Active NPI
Gerald H Fagen, RPH
- Pharmacist
- Valparaiso, IN
National Provider Identifier
1972083442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26016923A
- Practice address
- 2401 Valley Dr
Valparaiso, IN 46383-2520 - Phone
- (219) 413-5100
- NPI assigned
- Aug 15, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26016923A | IN | Primary |
Addresses
Primary practice location
2401 Valley Dr
Valparaiso, IN 46383-2520
Mailing address
42 Castleton Rd
Valparaiso, IN 46385-8846
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
| License | State | Type | Specialty |
|---|---|---|---|
| 26016923A | IN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688083200000",
"number": "1972083442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42 CASTLETON RD",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463858846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 VALLEY DR",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463832520",
"telephone_number": "219-413-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAGEN",
"first_name": "GERALD",
"middle_name": "H",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-15",
"last_updated": "2023-06-30",
"certification_date": "2023-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26016923A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valparaiso, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.