Individual provider Active NPI

Laura Alice Mudd, PHARMD, BCCCP

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Columbus, OH
National Provider Identifier
1245744978
Registry record updated Nov 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
03337678 Issued in OH
Practice address
410 W 10TH Ave
Columbus, OH 43210-1240
Phone
(614) 293-8470
Fax
(614) 293-3165
NPI assigned
Nov 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 03337678 OH Primary

Addresses

Primary practice location

410 W 10TH Ave
Columbus, OH 43210-1240

Mailing address

410 W 10TH Ave
368 Doan Hall
Columbus, OH 43210-1240
Phone (614) 293-8470

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

LicenseStateTypeSpecialty
03337678OHMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510790400000",
    "number": "1245744978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W 10TH AVE",
            "address_2": "368 DOAN HALL",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-293-8470",
            "fax_number": "614-293-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-293-8470",
            "fax_number": "614-293-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDD",
        "first_name": "LAURA",
        "middle_name": "ALICE",
        "name_prefix": "Dr.",
        "credential": "PHARMD, BCCCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-16",
        "last_updated": "2017-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OH",
            "license": "03337678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; 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.