Active NPI
Jason Phan, PHARMD
- Pharmacist
- Toledo, OH
National Provider Identifier
1205512936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03443158
- Practice address
- 3404 W Sylvania Ave
Toledo, OH 43623-4467 - Phone
- (419) 407-2663
- NPI assigned
- Jun 27, 2023
- 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 | 03443158 | OH | Primary |
Addresses
Primary practice location
3404 W Sylvania Ave
Toledo, OH 43623-4467
Mailing address
857 Valley Circle Dr Apt 103
Saline, MI 48176-1453
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03443158 | Other | OH | PHARMACIST LICENSE |
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 |
|---|---|---|---|
| 03443158 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687824000000",
"number": "1205512936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "857 VALLEY CIRCLE DR APT 103",
"city": "SALINE",
"state": "MI",
"postal_code": "481761453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3404 W SYLVANIA AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436234467",
"telephone_number": "419-407-2663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "JASON",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-27",
"last_updated": "2023-06-27",
"certification_date": "2023-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03443158",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "03443158",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.