Individual provider Active NPI

John A Bahlman III, RPH

  • Pharmacist
  • Prescott, AZ
National Provider Identifier
1306159504
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6079 Issued in AZ
Practice address
3198 Willow Creek Rd
Prescott, AZ 86301-6610
Phone
(928) 778-3181
Fax
(928) 778-3491
NPI assigned
Jul 16, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6079 AZ Primary

Addresses

Primary practice location

3198 Willow Creek Rd
Prescott, AZ 86301-6610

Mailing address

3198 Willow Creek Rd
Prescott, AZ 86301-6610
Phone (928) 778-3181

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
6079AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Smith'S Food & Drug Centers Inc Past Accepting new patients
Smiths Food & Drug Centers 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1306159504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3198 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863016610",
            "telephone_number": "928-778-3181",
            "fax_number": "928-778-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3198 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863016610",
            "telephone_number": "928-778-3181",
            "fax_number": "928-778-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHLMAN",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-16",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "6079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; 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.