Individual provider Active NPI

Kevin Edel, RPH

  • Pharmacist
  • Mesa, AZ
National Provider Identifier
1003238452
Registry record updated Jan 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S013588 Issued in AZ
Practice address
1955 S Stapley Dr
Mesa, AZ 85204-6615
Phone
(480) 892-0306
Fax
(480) 892-8214
NPI assigned
Jan 18, 2014
Last updated
Jan 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S013588 AZ Primary

Addresses

Primary practice location

1955 S Stapley Dr
Mesa, AZ 85204-6615

Mailing address

1955 S Stapley Dr
Mesa, AZ 85204-6615
Phone (480) 892-0306

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
S013588AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1390003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390003200000",
    "number": "1003238452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 S STAPLEY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046615",
            "telephone_number": "480-892-0306",
            "fax_number": "480-892-8214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 S STAPLEY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046615",
            "telephone_number": "480-892-0306",
            "fax_number": "480-892-8214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDEL",
        "first_name": "KEVIN",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-18",
        "last_updated": "2014-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S013588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.

Verify at the official NPI Registry.