Angela Nicole Renckly, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

S021436 Issued in AZ

Practice address

9003 E Shea Blvd
Scottsdale, AZ 85260-6709

Phone

(480) 323-3854

NPI assigned

Aug 10, 2015

Last updated

May 2, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Angela Nicole Walsh Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588377600000",
    "number": "1043696222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9003 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606709",
            "telephone_number": "480-323-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9003 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606709",
            "telephone_number": "480-323-3854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19829 N 27th Ave",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850274001",
            "country_code": "US",
            "telephone_number": "623-879-5612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENCKLY",
        "first_name": "ANGELA",
        "middle_name": "NICOLE",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-10",
        "last_updated": "2020-05-02",
        "certification_date": "2020-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S021436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "WALSH",
            "middle_name": "NICOLE",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pharmacist in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Pharmacist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2020; 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.