Active NPI
Branden Deaton, PHARM.D
- Pharmacist
- Tuba City, AZ
National Provider Identifier
1063716686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P6425
- Practice address
- 167 N. Main Street
Tuba City, AZ 86045 - Phone
- (928) 283-2754
- NPI assigned
- Dec 23, 2010
- Sex
- Male
- 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 | P6425 | ID | Primary |
Addresses
Primary practice location
167 N. Main Street
Tuba City, AZ 86045
Mailing address
P.O Box 600
167 N. Main Street
Tuba City, AZ 86045
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P6425 | Other | ID | PHARMACIST LICENSE |
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 |
|---|---|---|---|
| P6425 | ID | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293062400000",
"number": "1063716686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O BOX 600",
"address_2": "167 N. MAIN STREET",
"city": "TUBA CITY",
"state": "AZ",
"postal_code": "86045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "167 N. MAIN STREET",
"city": "TUBA CITY",
"state": "AZ",
"postal_code": "86045",
"telephone_number": "928-283-2754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEATON",
"first_name": "BRANDEN",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-12-23",
"last_updated": "2010-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P6425",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "P6425",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tuba City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.