Individual provider Active NPI

Alexander Chmura

  • Pharmacist
  • Kyle, SD
National Provider Identifier
1083291744
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5666 Issued in SD
Practice address
1000 Health Ctr Rd.
Kyle, SD 57752
Phone
(605) 455-8245
NPI assigned
Mar 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5666 SD Primary

Addresses

Primary practice location

1000 Health Ctr Rd.
Kyle, SD 57752

Mailing address

4613 Bozeman Cir
Rapid City, SD 57703-2108
Phone (605) 381-7316

Other practice location 1

607 Indian Health Rd
Pine Ridge, SD 57770-3169
Phone (605) 687-3192

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
5666SDMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1083291744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4613 BOZEMAN CIR",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577032108",
            "telephone_number": "605-381-7316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HEALTH CTR RD.",
            "city": "KYLE",
            "state": "SD",
            "postal_code": "57752",
            "telephone_number": "605-455-8245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "607 Indian Health Rd",
            "address_purpose": "LOCATION",
            "city": "Pine Ridge",
            "state": "SD",
            "postal_code": "577703169",
            "country_code": "US",
            "telephone_number": "605-687-3192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHMURA",
        "first_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-26",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SD",
            "license": "5666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kyle, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.