Active NPI
Kaitlyn Skulkan, PHARMD
- Pharmacist
- Phoenix, AZ
National Provider Identifier
1144602376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S022161
- Practice address
- 4875 E Elliot Rd
Phoenix, AZ 85044-1715 - Phone
- (480) 496-0019
- NPI assigned
- Jun 24, 2015
- Last updated
- Feb 15, 2023
- 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 | S022161 | AZ | Primary |
Addresses
Primary practice location
4875 E Elliot Rd
Phoenix, AZ 85044-1715
Mailing address
701 W. Mountain Sky Ave.
Phoenix, AZ 85045
Phone (480) 516-5933
Other practice location 1
7606 S 7th St
Phoenix, AZ 85042-6503
Phone (602) 243-1525
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 |
|---|---|---|---|
| S022161 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Smith's Food & Drug Centers Inc | Past | Accepting new patients | |
| Smiths Food & Drug Centers Inc | Past | Accepting new patients |
Locations
4875 E Elliot Rd
Phoenix, AZ 85044
Phone (480) 496-0019
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Frys Food and Drug
- Community/Retail Pharmacy
- Chandler, AZ
- NPI 1962445296
-
dba Smith's Pharmacy #303
- Community/Retail Pharmacy
- Henderson, NV
- NPI 1881585248
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676419200000",
"number": "1144602376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 W. MOUNTAIN SKY AVE.",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85045",
"telephone_number": "480-516-5933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4875 E ELLIOT RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850441715",
"telephone_number": "480-496-0019"
}
],
"practiceLocations": [
{
"address_1": "7606 S 7th St",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850426503",
"country_code": "US",
"telephone_number": "602-243-1525",
"fax_number": "602-243-0328",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SKULKAN",
"first_name": "KAITLYN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-24",
"last_updated": "2023-02-15",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S022161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.