Individual provider Active NPI

Ricky Gene Deweese, RPH

  • Pharmacist
  • Philadelphia, MS
National Provider Identifier
1972642205
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
E 6068 Issued in MS
Practice address
12491 Road 614
Philadelphia, MS 39350-5668
Phone
(601) 389-6567
NPI assigned
Feb 5, 2007
Last updated
Jun 1, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X E 6068 MS Primary

Addresses

Primary practice location

12491 Road 614
Philadelphia, MS 39350-5668

Mailing address

1001 Holland Ave
Philadelphia, MS 39350-2161
Phone (601) 781-2310

Other names 1

  • Mr. Ricky Gene Deweese Other name

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
E 6068MSMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1972642205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 HOLLAND AVE",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502161",
            "telephone_number": "601-781-2310",
            "fax_number": "601-781-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12491 ROAD 614",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393505668",
            "telephone_number": "601-389-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWEESE",
        "first_name": "RICKY",
        "middle_name": "GENE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E 6068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICKY",
            "last_name": "DEWEESE",
            "middle_name": "GENE",
            "prefix": "MR.",
            "credential": "RPH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Philadelphia, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; 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.