Individual provider Active NPI

Carole Simon, R.PH.

  • Pharmacist
  • Albuquerque, NM
National Provider Identifier
1073809661
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
4154 Issued in NM
Practice address
9371 Coors Blvd NW
Albuquerque, NM 87114-4005
Phone
(505) 899-7731
Fax
(505) 899-7731
NPI assigned
Jun 22, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 4154 NM Primary

Addresses

Primary practice location

9371 Coors Blvd NW
Albuquerque, NM 87114-4005

Mailing address

9371 Coors Blvd NW
Albuquerque, NM 87114-4005
Phone (505) 899-7731

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
4154NMMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1073809661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9371 COORS BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871144005",
            "telephone_number": "505-899-7731",
            "fax_number": "505-899-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9371 COORS BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871144005",
            "telephone_number": "505-899-7731",
            "fax_number": "505-899-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "CAROLE",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "4154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; 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.