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Deactivated NPI 1124301395 Deactivated / Inactive NPI Male Practitioner

Nelson Ajobodada Metitiri , RPH

Pharmacist • Fort Wayne, IN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Nelson Metitiri has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 23, 2011
NPI Deactivation Date June 13, 2022
Total Practice Duration ~11 Years of Practice (2011 – 2022)

Professional Overview & Biography Verified Profile Summary

Nelson Metitiri, RPH was a registered Pharmacist practicing in Fort Wayne, IN. Throughout an active medical career spanning 11 years, Nelson Metitiri provided care at the practice location at 110 E CREIGHTON AVE until profile deactivation on 2022-06-13.

Practice Location & Contact Primary Location

Practice Address

110 E Creighton Ave

Fort Wayne, IN 468033344

Telephone 2604561841
Fax 2604561538
Associated Practice Facility / Clinic
🏢 Walgreen Co Facility NPI 1598770638

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Fort Wayne, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
385 Specialists

Practicing in Fort Wayne, IN (5218 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License IN 26016243A

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1093167488
Dr. Mariah Vasquez , PharmD

Pharmacist - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI 1306465570

Doctor of Pharmacy (Pharm.D.)

NPI 1396028171

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 13, 2022

Record deactivated on June 13, 2022

NPI Profile Active September 23, 2011

NPI status registered as active in NPPES database

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Updated Practice Location September 23, 2011

Registered at 110 E CREIGHTON AVE, FORT WAYNE, IN 468033344 (Tel: 2604561841)

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Updated Business Mailing Address September 23, 2011

Registered at 110 E CREIGHTON AVE, FORT WAYNE, IN 468033344 (Tel: 2604561841)

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Provider Name / Credentials Updated September 23, 2011

Recorded as NELSON METITIRI, R.PH

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 23, 2011

Pharmacist (License #26016243A in IN)

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Initial NPI Registration & Enumeration September 23, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124301395
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 23, 2011
Last Update: September 23, 2011
Deactivation Date: June 13, 2022

Mailing Address

110 E Creighton Ave

Fort Wayne, IN 468033344

Phone: 2604561841

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.