Individual provider Active NPI

Donovan Terry, PHARMD

  • Pharmacist
  • Mesa, AZ
National Provider Identifier
1164901682
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S019333 Issued in AZ
Practice address
6644 E Baywood Ave
Mesa, AZ 85206-1747
Phone
(480) 321-4134
NPI assigned
Aug 7, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S019333 AZ Primary

Addresses

Primary practice location

6644 E Baywood Ave
Mesa, AZ 85206-1747

Mailing address

4900 W Flint St
Chandler, AZ 85226-2966

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

LicenseStateTypeSpecialty
S019333AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1164901682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 W FLINT ST",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6644 E BAYWOOD AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061747",
            "telephone_number": "480-321-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "DONOVAN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S019333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.