Active NPI
Idia Tokunboh, PHARM D.
- Pharmacist
- Wichita, KS
National Provider Identifier
1043689078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 1-16393
- Practice address
- 4794 E 13TH St N
Wichita, KS 67208-2204 - Phone
- (316) 361-3387
- NPI assigned
- Sep 21, 2015
- Last updated
- Sep 21, 2015
- 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 | 1-16393 | KS | Primary |
Addresses
Primary practice location
4794 E 13TH St N
Wichita, KS 67208-2204
Mailing address
11710 W Ryan St
Wichita, KS 67205-2196
Phone (316) 409-8800
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 |
|---|---|---|---|
| 1-16393 | KS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442793600000",
"number": "1043689078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11710 W RYAN ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672052196",
"telephone_number": "316-409-8800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4794 E 13TH ST N",
"city": "WICHITA",
"state": "KS",
"postal_code": "672082204",
"telephone_number": "316-361-3387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOKUNBOH",
"first_name": "IDIA",
"name_prefix": "Dr.",
"credential": "PHARM D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-21",
"last_updated": "2015-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KS",
"license": "1-16393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.