Individual provider Active NPI

Dylan Doner, PHARMD

  • Pharmacist
  • Lafayette, IN
National Provider Identifier
1295380202
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26028320A Issued in IN
Practice address
4901 State Road 26 E
Lafayette, IN 47905-4611
Phone
(765) 449-9210
Fax
(765) 449-9265
NPI assigned
Aug 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26028320A IN Primary

Addresses

Primary practice location

4901 State Road 26 E
Lafayette, IN 47905-4611

Mailing address

404 Brunswick Dr Apt 13
Lafayette, IN 47909-6979
Phone (765) 993-7658

Other identifiers 1

IdentifierTypeStateIssuer
26028320AOtherINSTATE PHARMACY BOARD

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
26028320AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1295380202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 BRUNSWICK DR APT 13",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479096979",
            "telephone_number": "765-993-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 STATE ROAD 26 E",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054611",
            "telephone_number": "765-449-9210",
            "fax_number": "765-449-9265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONER",
        "first_name": "DYLAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26028320A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY BOARD",
            "identifier": "26028320A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.