Active NPI
Zachary D Smith, PHARMD
- Pharmacist
- Fort Wayne, IN
National Provider Identifier
1265716385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26023729A
- Practice address
- 2410 N Coliseum Blvd
Fort Wayne, IN 46805-3110 - Phone
- (260) 483-5612
- NPI assigned
- Oct 7, 2011
- Last updated
- Oct 7, 2011
- 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 | 26023729A | IN | Primary |
| Pharmacist | 183500000X | RPH.03230322-2 | OH |
Addresses
Primary practice location
2410 N Coliseum Blvd
Fort Wayne, IN 46805-3110
Mailing address
9834 Dupont Lakes Dr
Apt 3B
Fort Wayne, IN 46825
Phone (419) 203-3182
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 |
|---|---|---|---|
| 26023729A | IN | MD | Pharmacist |
| RPH.03230322-2 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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": "1317945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317945600000",
"number": "1265716385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9834 DUPONT LAKES DR",
"address_2": "APT 3B",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "46825",
"telephone_number": "419-203-3182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2410 N COLISEUM BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468053110",
"telephone_number": "260-483-5612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "ZACHARY",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-07",
"last_updated": "2011-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26023729A",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "RPH.03230322-2",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.