Active NPI
Silas Mwesigwa Kibazo, PHARM.D
- Pharmacist
- Queen Creek, AZ
National Provider Identifier
1164702205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S018662
- Practice address
- 3111 W Hunt Hwy
Queen Creek, AZ 85142-9357 - Phone
- (480) 214-2561
- NPI assigned
- Aug 21, 2011
- Last updated
- Aug 21, 2011
- 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 | S018662 | AZ | Primary |
Addresses
Primary practice location
3111 W Hunt Hwy
Queen Creek, AZ 85142-9357
Mailing address
28282 N Castle Rock Dr
Queen Creek, AZ 85143-6780
Phone (617) 240-7663
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 |
|---|---|---|---|
| S018662 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313884800000",
"number": "1164702205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28282 N CASTLE ROCK DR",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851436780",
"telephone_number": "617-240-7663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3111 W HUNT HWY",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851429357",
"telephone_number": "480-214-2561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIBAZO",
"first_name": "SILAS",
"middle_name": "MWESIGWA",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-21",
"last_updated": "2011-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S018662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queen Creek, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.