Individual provider Active NPI

Alexis Grace Roberts

  • Pharmacist
  • Mesa, AZ
National Provider Identifier
1295562015
Registry record updated Jan 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S027223 Issued in AZ
Practice address
1606 S Signal Butte Rd
Mesa, AZ 85209-1482
Phone
(480) 358-9731
NPI assigned
Sep 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S027223 AZ Primary

Addresses

Primary practice location

1606 S Signal Butte Rd
Mesa, AZ 85209-1482

Mailing address

1606 S Signal Butte Rd
Mesa, AZ 85209-1482
Phone (480) 358-9731

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

State licenses

LicenseStateTypeSpecialty
S027223AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737849600000",
    "number": "1295562015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 S SIGNAL BUTTE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852091482",
            "telephone_number": "480-358-9731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 S SIGNAL BUTTE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852091482",
            "telephone_number": "480-358-9731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ALEXIS",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2025-01-26",
        "certification_date": "2025-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S027223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2025; 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.