Individual provider Active NPI

Jeff Morris Vanarsdale, RPH

  • Pharmacist
  • Louisville, KY
National Provider Identifier
1366725244
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
011504 Issued in KY
Practice address
7914 Fegenbush LN
Louisville, KY 40228-1712
Phone
(502) 231-1788
NPI assigned
Sep 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 011504 KY Primary

Addresses

Primary practice location

7914 Fegenbush LN
Louisville, KY 40228-1712

Mailing address

1304 Blackthorn Rd
Louisville, KY 40299-4882
Phone (502) 749-0675

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
011504KYMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1366725244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 BLACKTHORN RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402994882",
            "telephone_number": "502-749-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7914 FEGENBUSH LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402281712",
            "telephone_number": "502-231-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANARSDALE",
        "first_name": "JEFF",
        "middle_name": "MORRIS",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-27",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "011504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.

Verify at the official NPI Registry.