Individual provider Active NPI

Grace Chang

  • Pharmacist
  • Chandler, AZ
National Provider Identifier
1134313513
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14522 Issued in AZ
Practice address
975 E Ocotillo Rd
Chandler, AZ 85249-3013
Phone
(314) 744-4109
NPI assigned
Aug 29, 2007
Last updated
Apr 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S014522 AZ
Pharmacist 183500000X 58519 CA
Pharmacist 183500000X 14522 AZ Primary

Addresses

Primary practice location

975 E Ocotillo Rd
Chandler, AZ 85249-3013

Mailing address

975 E Ocotillo Rd
Chandler, AZ 85249-3013
Phone (314) 744-4109

Other practice location 1

12647 Olive Blvd
Suite 600
Saint Louis, MO 63141-6345
Phone (314) 744-4109

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
14522AZMDPharmacist
S014522AZMDPharmacist
58519CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1134313513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 E OCOTILLO RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852493013",
            "telephone_number": "314-744-4109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E OCOTILLO RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852493013",
            "telephone_number": "314-744-4109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12647 Olive Blvd",
            "address_2": "Suite 600",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631416345",
            "country_code": "US",
            "telephone_number": "314-744-4109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S014522",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "58519",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "14522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.