Individual provider Active NPI

Denise Roque, PHARMD

  • Pharmacist
  • Kansas City, MO
National Provider Identifier
1174890875
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2008027468 Issued in MO
Practice address
3537 Broadway Blvd
Kansas City, MO 64111-2501
Phone
(816) 561-1933
Fax
(816) 753-5938
NPI assigned
Nov 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 1-14441 KS
Pharmacist 183500000X 2008027468 MO Primary

Addresses

Primary practice location

3537 Broadway Blvd
Kansas City, MO 64111-2501

Mailing address

25130 W 105TH Ter
Olathe, KS 66061-7654
Phone (785) 249-4050

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
1-14441KSMDPharmacist
2008027468MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince May 8, 2022 Accepting new patients
Walgreen Co PastSince Apr 26, 2020 Accepting new patients

Locations

3537 Broadway Blvd
Kansas City, MO 64111
Phone (816) 561-1922

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1174890875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25130 W 105TH TER",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660617654",
            "telephone_number": "785-249-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3537 BROADWAY BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112501",
            "telephone_number": "816-561-1933",
            "fax_number": "816-753-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROQUE",
        "first_name": "DENISE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-23",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-14441",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2008027468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.