Individual provider Active NPI

Cornelius Ebai Tanyi

  • Pharmacist
  • Mesa, AZ
National Provider Identifier
1053611467
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S011361 Issued in AZ
Practice address
1225 W Guadalupe Rd
Mesa, AZ 85202-9101
Phone
(480) 838-7720
NPI assigned
Nov 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S011361 AZ Primary

Addresses

Primary practice location

1225 W Guadalupe Rd
Mesa, AZ 85202-9101

Mailing address

1225 W Guadalupe Rd
Mesa, AZ 85202-9101

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

State licenses

LicenseStateTypeSpecialty
S011361AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288569600000",
    "number": "1053611467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 W GUADALUPE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852029101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W GUADALUPE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852029101",
            "telephone_number": "480-838-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANYI",
        "first_name": "CORNELIUS",
        "middle_name": "EBAI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-01",
        "last_updated": "2010-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S011361",
            "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 Nov 1, 2010; 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.