Active NPI
Daniel Tawiah Tetteh, PHARMD
- Pharmacist
- Parker, AZ
National Provider Identifier
1255807772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S023619
- Practice address
- 100 W Riverside Dr
Parker, AZ 85344-5205 - Phone
- (928) 669-8306
- NPI assigned
- Oct 23, 2018
- Last updated
- Oct 23, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PHA.0022471 | CO | |
| Pharmacist | 183500000X | S023619 | AZ | Primary |
Addresses
Primary practice location
100 W Riverside Dr
Parker, AZ 85344-5205
Mailing address
100 W Riverside Dr
Parker, AZ 85344-5205
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHA.0022471 | Other | CO | BOARD OF PHARMACY |
| S023619 | Other | AZ | BOARD OF PHARMACY |
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 |
|---|---|---|---|
| S023619 | AZ | MD | Pharmacist |
| PHA.0022471 | CO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | Past | Accepting new patients |
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": "1540252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540252800000",
"number": "1255807772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 W RIVERSIDE DR",
"city": "PARKER",
"state": "AZ",
"postal_code": "853445205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 W RIVERSIDE DR",
"city": "PARKER",
"state": "AZ",
"postal_code": "853445205",
"telephone_number": "928-669-8306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TETTEH",
"first_name": "DANIEL",
"middle_name": "TAWIAH",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-10-23",
"last_updated": "2018-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "PHA.0022471",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S023619",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHARMACY",
"identifier": "PHA.0022471",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHARMACY",
"identifier": "S023619",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Parker, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.