Active NPI
Patricia Dietrich
- Pharmacist
- Plain Dealing, LA
National Provider Identifier
1992115695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15876
- Practice address
- 302 E Palmetto
Plain Dealing, LA 71064 - Phone
- (318) 326-4229
- NPI assigned
- May 2, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15876 | LA | Primary |
| Pharmacist | 183500000X | 12078 | OR |
Addresses
Primary practice location
302 E Palmetto
Plain Dealing, LA 71064
Mailing address
146 Twin Point Dr
Benton, LA 71006-8701
Phone (318) 349-6669
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15876 | LA | MD | Pharmacist |
| 12078 | OR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kelly Pharmacy Inc Kelly Pharmacy & Gifts | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Plain Dealing, LA
- NPI 1760576011
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398988800000",
"number": "1992115695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "146 TWIN POINT DR",
"city": "BENTON",
"state": "LA",
"postal_code": "710068701",
"telephone_number": "318-349-6669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 E PALMETTO",
"city": "PLAIN DEALING",
"state": "LA",
"postal_code": "71064",
"telephone_number": "318-326-4229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETRICH",
"first_name": "PATRICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-02",
"last_updated": "2014-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "15876",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "12078",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plain Dealing, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.