Active NPI
Ryan Yazback, PHARMD
- Pharmacist
- Dearborn, MI
National Provider Identifier
1235851411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302414607
- Practice address
- 15325 Michigan Ave
Dearborn, MI 48126-2954 - Phone
- (313) 582-9422
- NPI assigned
- Sep 14, 2022
- Last updated
- Sep 14, 2022
- 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 | 5302414607 | MI | Primary |
Addresses
Primary practice location
15325 Michigan Ave
Dearborn, MI 48126-2954
Mailing address
4853 Westland St
Dearborn, MI 48126-4112
Phone (313) 333-0896
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 |
|---|---|---|---|
| 5302414607 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodward Detroit CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 1
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": "1663113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663113600000",
"number": "1235851411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4853 WESTLAND ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481264112",
"telephone_number": "313-333-0896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15325 MICHIGAN AVE",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481262954",
"telephone_number": "313-582-9422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAZBACK",
"first_name": "RYAN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-14",
"last_updated": "2022-09-14",
"certification_date": "2022-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302414607",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.