Individual provider Active NPI

Kathryn Kayle Prochaska, RPH

  • Pharmacist
  • Yuma, AZ
National Provider Identifier
1215112503
Registry record updated Jan 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S006247 Issued in AZ
Practice address
2060 W 24TH St
Yuma, AZ 85364-6123
Phone
(928) 819-8941
Fax
(928) 376-6606
NPI assigned
Jan 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S006247 AZ Primary

Addresses

Primary practice location

2060 W 24TH St
Yuma, AZ 85364-6123

Mailing address

2060 W 24TH St
Yuma, AZ 85364-6123
Phone (928) 819-8941

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
S006247AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199404800000",
    "number": "1215112503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 W 24TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646123",
            "telephone_number": "928-819-8941",
            "fax_number": "928-376-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 W 24TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646123",
            "telephone_number": "928-819-8941",
            "fax_number": "928-376-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCHASKA",
        "first_name": "KATHRYN",
        "middle_name": "KAYLE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-04",
        "last_updated": "2008-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S006247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; 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.