Active NPI
Spencer Sherman
- Pharmacist
- Peoria, AZ
National Provider Identifier
1114648334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S025989
- Practice address
- 24865 N Lake Pleasant Pkwy
Peoria, AZ 85383-1280 - Phone
- (623) 566-1110
- NPI assigned
- Sep 6, 2022
- Sex
- Male
- 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 | S025989 | AZ | Primary |
Addresses
Primary practice location
24865 N Lake Pleasant Pkwy
Peoria, AZ 85383-1280
Mailing address
31113 N North Valley Pkwy Apt 3125
Phoenix, AZ 85085-5119
Phone (951) 795-5576
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
| License | State | Type | Specialty |
|---|---|---|---|
| S025989 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arizona CVS Stores LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pharmacy
- Peoria, AZ
- NPI 1134549181
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662422400000",
"number": "1114648334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31113 N NORTH VALLEY PKWY APT 3125",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850855119",
"telephone_number": "951-795-5576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24865 N LAKE PLEASANT PKWY",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853831280",
"telephone_number": "623-566-1110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERMAN",
"first_name": "SPENCER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-06",
"last_updated": "2022-09-06",
"certification_date": "2022-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S025989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.