Individual provider Active NPI

Evan James Vickers, R.PH

  • Pharmacist
  • Cedar City, UT
National Provider Identifier
1306845730
Registry record updated Jun 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
1436311701 Issued in UT
Practice address
91 N Main St
Cedar City, UT 84720-2648
Phone
(435) 586-9651
Fax
(435) 586-3473
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 1436311701 UT Primary

Addresses

Primary practice location

91 N Main St
Cedar City, UT 84720-2648

Mailing address

2166 N Cobblecreek Dr
Cedar City, UT 84721-9714
Phone (435) 586-4399

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
1436311701UTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Richfield Community Pharmacy LLC Current Accepting new patients
Township Pharmacy L L C Current Accepting new patients
Ejvf LLC Past Accepting new patients

Locations

91 N Main St
Cedar City, UT 84720
Phone (435) 586-9651

Organizations & group practices 3

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245196800000",
    "number": "1306845730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2166 N COBBLECREEK DR",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847219714",
            "telephone_number": "435-586-4399",
            "fax_number": "435-586-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 N MAIN ST",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847202648",
            "telephone_number": "435-586-9651",
            "fax_number": "435-586-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "EVAN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2009-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "1436311701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; 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.