Active NPI
Sandra Jean Johnson, PHARMD
- Pharmacist
- Peoria, AZ
National Provider Identifier
1043655764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S12634
- Practice address
- 6817 W Peoria Ave
Peoria, AZ 85345-9324 - Phone
- (623) 878-5028
- Fax
- (623) 878-5075
- NPI assigned
- May 8, 2013
- 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 | S12634 | AZ | Primary |
Addresses
Primary practice location
6817 W Peoria Ave
Peoria, AZ 85345-9324
Mailing address
4141 W Paradise LN
Phoenix, AZ 85053-3713
Phone (623) 878-5028
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 |
|---|---|---|---|
| S12634 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | 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
- Queen Creek, AZ
- NPI 1730040973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367971200000",
"number": "1043655764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4141 W PARADISE LN",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850533713",
"telephone_number": "623-878-5028",
"fax_number": "623-878-5075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6817 W PEORIA AVE",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853459324",
"telephone_number": "623-878-5028",
"fax_number": "623-878-5075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "SANDRA",
"middle_name": "JEAN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-08",
"last_updated": "2013-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S12634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.