Active NPI
Lucas Gary Roberts, PHARMD
- Pharmacist
- Kailua Kona, HI
National Provider Identifier
1972897296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2944
- Practice address
- 74-5455 Makala Blvd
Kailua Kona, HI 96740-2727 - Phone
- (808) 334-4021
- NPI assigned
- Jun 3, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2944 | HI | Primary |
| Pharmacist | 183500000X | 0011783 | OR |
Addresses
Primary practice location
74-5455 Makala Blvd
Kailua Kona, HI 96740-2727
Mailing address
74-5455 Makala Blvd
Kailua Kona, HI 96740-2727
Phone (808) 334-4021
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2944 | HI | MD | Clinical Social Worker |
| 0011783 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307059200000",
"number": "1972897296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74-5455 MAKALA BLVD",
"city": "KAILUA KONA",
"state": "HI",
"postal_code": "967402727",
"telephone_number": "808-334-4021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74-5455 MAKALA BLVD",
"city": "KAILUA KONA",
"state": "HI",
"postal_code": "967402727",
"telephone_number": "808-334-4021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "LUCAS",
"middle_name": "GARY",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-03",
"last_updated": "2011-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "HI",
"license": "2944",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "0011783",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kailua Kona, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.