Active NPI
Jeff Cory Davis, RPH
- Pharmacist
- Yuma, AZ
National Provider Identifier
1316222649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S07895
- Practice address
- 2378 W 24TH St
Yuma, AZ 85364-6124 - Phone
- (928) 343-2311
- Fax
- (928) 343-2325
- NPI assigned
- Oct 18, 2011
- Last updated
- Oct 19, 2011
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | S07895 | AZ | Primary |
Addresses
Primary practice location
2378 W 24TH St
Yuma, AZ 85364-6124
Mailing address
2378 W 24TH St
Yuma, AZ 85364-6124
Phone (928) 343-2311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2207 | Other | AZ | IMMUNIZER LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| S07895 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albertsons LLC | Past | Accepting new patients | |
| Albertsons LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318982400000",
"number": "1316222649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2378 W 24TH ST",
"city": "YUMA",
"state": "AZ",
"postal_code": "853646124",
"telephone_number": "928-343-2311",
"fax_number": "928-343-2325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2378 W 24TH ST",
"city": "YUMA",
"state": "AZ",
"postal_code": "853646124",
"telephone_number": "928-343-2311",
"fax_number": "928-343-2325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JEFF",
"middle_name": "CORY",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-18",
"last_updated": "2011-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S07895",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IMMUNIZER LICENSE",
"identifier": "2207",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yuma, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.