Individual provider Active NPI

Ashley Beth Prusakov, PHARMD

  • Pharmacist
  • Columbus, OH
National Provider Identifier
1023684941
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03334892 Issued in OH
Practice address
700 Childrens Dr
Columbus, OH 43205-2639
Phone
(614) 722-2000
NPI assigned
Jun 1, 2021
Last updated
Jun 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.297686 IL
Pharmacist 183500000X 75614 CA
Pharmacist 183500000X 23400 CO
Pharmacist 183500000X 03334892 OH Primary

Addresses

Primary practice location

700 Childrens Dr
Columbus, OH 43205-2639

Mailing address

801 Timberman Rd
Columbus, OH 43212-3816
Phone (719) 433-3255

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

LicenseStateTypeSpecialty
75614CAMDPharmacist
23400COMDPharmacist
051.297686ILMDPharmacist
03334892OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1023684941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 TIMBERMAN RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432123816",
            "telephone_number": "719-433-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052639",
            "telephone_number": "614-722-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSAKOV",
        "first_name": "ASHLEY",
        "middle_name": "BETH",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.297686",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "75614",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "23400",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03334892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.