Individual provider Active NPI

Jason Jay Kean

  • Pharmacy Technician
  • Surprise, AZ
National Provider Identifier
1356959571
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
T069665 Issued in AZ
Practice address
15300 N Cotton LN
Surprise, AZ 85388-9613
Phone
(623) 584-8558
NPI assigned
Jul 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X T069665 AZ Primary

Addresses

Primary practice location

15300 N Cotton LN
Surprise, AZ 85388-9613

Mailing address

15300 N Cotton LN
Surprise, AZ 85388-9613
Phone (623) 584-8558

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

State licenses

LicenseStateTypeSpecialty
T069665AZMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
German Dobson CVS LLC CurrentSince Apr 14, 2024 Accepting new patients
German Dobson CVS LLC PastSince Jul 27, 2020 Accepting new patients

Locations

15300 N Cotton Ln
Surprise, AZ 85388
Phone (623) 584-8558

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": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1356959571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15300 N COTTON LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853889613",
            "telephone_number": "623-584-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 N COTTON LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853889613",
            "telephone_number": "623-584-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEAN",
        "first_name": "JASON",
        "middle_name": "JAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "AZ",
            "license": "T069665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.