Active NPI
Jason Donovan, PHARMD
- Nutrition Support Pharmacist
- Merriam, KS
National Provider Identifier
1306586078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Support Pharmacist
- License
- 1106838
- Practice address
- 5203 Garner LN
Merriam, KS 66203-2063 - Phone
- (913) 982-7281
- NPI assigned
- Mar 31, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Support Pharmacist | 1835N1003X | 1106838 | KS | Primary |
Addresses
Primary practice location
5203 Garner LN
Merriam, KS 66203-2063
Mailing address
5203 Garner LN
Merriam, KS 66203-2063
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 |
|---|---|---|---|
| 1106838 | KS | MD | Nutrition Support Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648684800000",
"number": "1306586078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5203 GARNER LN",
"city": "MERRIAM",
"state": "KS",
"postal_code": "662032063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5203 GARNER LN",
"city": "MERRIAM",
"state": "KS",
"postal_code": "662032063",
"telephone_number": "913-982-7281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONOVAN",
"first_name": "JASON",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-31",
"last_updated": "2022-03-31",
"certification_date": "2021-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "1835N1003X",
"taxonomy_group": "",
"desc": "Pharmacist, Nutrition Support",
"state": "KS",
"license": "1106838",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merriam, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.