Active NPI
Cody Ray Plaisted, PHARM. D
- Pharmacist
- Flagstaff, AZ
National Provider Identifier
1083901763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3450
- Practice address
- 3480 E Route 66
Flagstaff, AZ 86004-4032 - Phone
- (307) 399-5957
- NPI assigned
- Jul 1, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3450 | WY | Primary |
| Pharmacist | 183500000X | S019113 | AZ |
Addresses
Primary practice location
3480 E Route 66
Flagstaff, AZ 86004-4032
Mailing address
3480 E Route 66
Flagstaff, AZ 86004-4032
Phone (307) 399-5957
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 |
|---|---|---|---|
| S019113 | AZ | MD | Pharmacist |
| 3450 | WY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380672000000",
"number": "1083901763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3480 E ROUTE 66",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860044032",
"telephone_number": "307-399-5957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3480 E ROUTE 66",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860044032",
"telephone_number": "307-399-5957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLAISTED",
"first_name": "CODY",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "PHARM. D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-01",
"last_updated": "2013-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WY",
"license": "3450",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S019113",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.