Individual provider Active NPI

Lily Doan, DOCTOR OF PHARMACY

  • Pharmacist
  • Albuquerque, NM
National Provider Identifier
1205694338
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP00010097 Issued in NM
Practice address
10300 Central Ave SE
Albuquerque, NM 87123-2732
Phone
(505) 292-0917
NPI assigned
Mar 12, 2024
Last updated
Apr 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP00010097 NM Primary

Addresses

Primary practice location

10300 Central Ave SE
Albuquerque, NM 87123-2732

Mailing address

904 Tumulus Dr NW
Albuquerque, NM 87120-1098
Phone (505) 720-7341

Other practice location 1

4700 4th St NW
Albuquerque, NM 87107-3902
Phone (505) 344-1390

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

State licenses

LicenseStateTypeSpecialty
RP00010097NMMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Mar 24, 2024 Accepting new patients
Walgreen Co PastSince Mar 24, 2024 Accepting new patients

Locations

10300 Central Ave SE
Albuquerque, NM 87123
Phone (505) 292-0917

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": "1710201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1205694338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 TUMULUS DR NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201098",
            "telephone_number": "505-720-7341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 CENTRAL AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871232732",
            "telephone_number": "505-292-0917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 4th St NW",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871073902",
            "country_code": "US",
            "telephone_number": "505-344-1390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOAN",
        "first_name": "LILY",
        "credential": "DOCTOR OF PHARMACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-12",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "RP00010097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.