Active NPI
Ebony Dawn Thomas, PHARMD
- Pharmacist
- Apple Valley, CA
National Provider Identifier
1114354628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 69754
- Practice address
- 19201 Bear Valley Rd
Apple Valley, CA 92308-2702 - Phone
- (760) 247-4111
- NPI assigned
- Sep 28, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 69754 | CA | Primary |
Addresses
Primary practice location
19201 Bear Valley Rd
Apple Valley, CA 92308-2702
Mailing address
16653 Desert Lily St
Victorville, CA 92394-1426
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 |
|---|---|---|---|
| 69754 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380326400000",
"number": "1114354628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16653 DESERT LILY ST",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923941426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19201 BEAR VALLEY RD",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923082702",
"telephone_number": "760-247-4111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "EBONY",
"middle_name": "DAWN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-28",
"last_updated": "2013-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "69754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Apple Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.