Individual provider Active NPI

Joshua Roehrick

  • Pharmacist
  • Des Moines, IA
National Provider Identifier
1104447606
Registry record updated May 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
22914 Issued in IA
Practice address
3140 SE 14TH St
Des Moines, IA 50320-1328
Phone
(515) 282-5295
Fax
(515) 282-7057
NPI assigned
May 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 22914 IA Primary

Addresses

Primary practice location

3140 SE 14TH St
Des Moines, IA 50320-1328

Mailing address

3140 SE 14TH St
Des Moines, IA 50320-1328
Phone (515) 282-5295

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
22914IAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince May 10, 2020 Accepting new patients
Walgreen Co PastSince May 10, 2020 Accepting new patients

Organizations & group practices 2

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": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1104447606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 SE 14TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503201328",
            "telephone_number": "515-282-5295",
            "fax_number": "515-282-7057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 SE 14TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503201328",
            "telephone_number": "515-282-5295",
            "fax_number": "515-282-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEHRICK",
        "first_name": "JOSHUA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-06",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "22914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; 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.