Individual provider Active NPI

Aubrey Fanning, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Lake Havasu City, AZ
National Provider Identifier
1083034086
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
S019915 Issued in AZ
Practice address
80 Acoma Blvd N
Lake Havasu City, AZ 86403-6932
Phone
(928) 680-4449
NPI assigned
Apr 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S019915 AZ
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X S019915 AZ Primary

Addresses

Primary practice location

80 Acoma Blvd N
Lake Havasu City, AZ 86403-6932

Mailing address

80 Acoma Blvd N
Lake Havasu City, AZ 86403-6932
Phone (928) 680-4449

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

LicenseStateTypeSpecialty
S019915AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Smith'S Food & Drug Centers Inc Past Accepting new patients
Smiths Food & Drug Centers Inc Past Accepting new patients
Arizona CVS Stores LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1083034086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 ACOMA BLVD N",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036932",
            "telephone_number": "928-680-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 ACOMA BLVD N",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036932",
            "telephone_number": "928-680-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNING",
        "first_name": "AUBREY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-17",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S019915",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "AZ",
            "license": "S019915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; 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.