Active NPI
David Terry, RPH
- Pharmacist
- Sierra Vista, AZ
National Provider Identifier
1336553866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S020077
- Practice address
- 2090 E Fry Blvd
Sierra Vista, AZ 85635-2707 - Phone
- (520) 458-1254
- Fax
- (520) 515-0753
- NPI assigned
- Jun 12, 2014
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | S020077 | AZ | Primary |
Addresses
Primary practice location
2090 E Fry Blvd
Sierra Vista, AZ 85635-2707
Mailing address
2090 E Fry Blvd
Sierra Vista, AZ 85635-2707
Phone (520) 458-1254
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 |
|---|---|---|---|
| S020077 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arizona CVS Stores LLC | Past | Accepting new patients | |
| Arizona CVS Stores 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402531200000",
"number": "1336553866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2090 E FRY BLVD",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "856352707",
"telephone_number": "520-458-1254",
"fax_number": "520-515-0753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2090 E FRY BLVD",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "856352707",
"telephone_number": "520-458-1254",
"fax_number": "520-515-0753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERRY",
"first_name": "DAVID",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-12",
"last_updated": "2014-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S020077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sierra Vista, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.