Active NPI
Phelicisima Weaver Roberts, RPH, PHARMD
- Pharmacist
- Louisville, KY
National Provider Identifier
1972783496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 011587
- Practice address
- 12501 Shelbyville Rd
Louisville, KY 40243-1530 - Phone
- (502) 244-7961
- NPI assigned
- Nov 13, 2007
- Sex
- Female
- 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 | 011587 | KY | Primary |
Addresses
Primary practice location
12501 Shelbyville Rd
Louisville, KY 40243-1530
Mailing address
1220 Long Ridge Trce
Louisville, KY 40245-4370
Phone (502) 254-3219
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011587 | KY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194912000000",
"number": "1972783496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1220 LONG RIDGE TRCE",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402454370",
"telephone_number": "502-254-3219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12501 SHELBYVILLE RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402431530",
"telephone_number": "502-244-7961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "PHELICISIMA",
"middle_name": "WEAVER",
"name_prefix": "Mrs.",
"credential": "RPH, PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-13",
"last_updated": "2007-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "011587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.