Active NPI
Karen Chemodurow, PHARM.D.
- Pharmacist
- Mesa, AZ
National Provider Identifier
1043629934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S020762
- Practice address
- 1130 W Southern Ave
Mesa, AZ 85210-4993 - Phone
- (480) 461-1193
- NPI assigned
- Aug 5, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S020762 | AZ | Primary |
Addresses
Primary practice location
1130 W Southern Ave
Mesa, AZ 85210-4993
Mailing address
6505 E Desert Cove Ave
Scottsdale, AZ 85254-5053
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 |
|---|---|---|---|
| S020762 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | 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.
-
- Pharmacy
- Mesa, AZ
- NPI 1063428423
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407196800000",
"number": "1043629934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6505 E DESERT COVE AVE",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852545053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 W SOUTHERN AVE",
"city": "MESA",
"state": "AZ",
"postal_code": "852104993",
"telephone_number": "480-461-1193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEMODUROW",
"first_name": "KAREN",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-05",
"last_updated": "2014-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S020762",
"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 Aug 5, 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.