Individual provider Active NPI

Chaetali Mortimer, PHARMD

  • Pharmacist
  • Dallas, TX
National Provider Identifier
1073426417
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
77898 Issued in TX
Practice address
11661 Preston Rd
Dallas, TX 75230-2745
Phone
(214) 363-1571
NPI assigned
Sep 25, 2026
Last updated
Sep 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193200000X MULTI-SPECIALTY GROUP 183500000X 77898 TX Primary

Addresses

Primary practice location

11661 Preston Rd
Dallas, TX 75230-2745

Mailing address

9145 Stone Creek PL
Dallas, TX 75243-6227
Phone (206) 724-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1073426417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9145 STONE CREEK PL",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752436227",
            "telephone_number": "206-724-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11661 PRESTON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302745",
            "telephone_number": "214-363-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTIMER",
        "first_name": "CHAETALI",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-25",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "77898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.