Individual provider Active NPI

Ryan Russell Schupbach, PHARM.D.

  • Pharmacotherapy Pharmacist
  • Claremore, OK
National Provider Identifier
1376549931
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
12872 Issued in OK
Practice address
101 S Moore Ave
Claremore, OK 74017-5047
Phone
(918) 342-6455
Fax
(918) 342-6330
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 12872 OK Primary

Addresses

Primary practice location

101 S Moore Ave
Claremore, OK 74017-5047

Mailing address

101 S Moore Ave
Claremore, OK 74017-5047
Phone (918) 342-6455

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
12872OKMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220400000000",
    "number": "1376549931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S MOORE AVE",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740175047",
            "telephone_number": "918-342-6455",
            "fax_number": "918-342-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S MOORE AVE",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740175047",
            "telephone_number": "918-342-6455",
            "fax_number": "918-342-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUPBACH",
        "first_name": "RYAN",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2008-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "OK",
            "license": "12872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; 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.