Individual provider Active NPI

Glenn Ray Christian Jr., RPH

  • Pharmacist
  • Shawnee, OK
National Provider Identifier
1245151364
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11596 Issued in OK
Practice address
4500 N Kickapoo Ave
Shawnee, OK 74804-1208
Phone
(405) 878-0247
NPI assigned
Jul 23, 2026
Last updated
Jul 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11596 OK Primary

Addresses

Primary practice location

4500 N Kickapoo Ave
Shawnee, OK 74804-1208

Mailing address

6809 S Shartel Ave
Oklahoma City, OK 73139-4313
Phone (405) 878-0247

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
11596OKMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1784764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1245151364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6809 S SHARTEL AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731394313",
            "telephone_number": "405-878-0247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 N KICKAPOO AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041208",
            "telephone_number": "405-878-0247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIAN",
        "first_name": "GLENN",
        "middle_name": "RAY",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-23",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "11596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.