Active NPI
Troy Waddell, RPH
- Pharmacist
- Corning, IA
National Provider Identifier
1386283364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17673
- Practice address
- 625 Davis Ave
Corning, IA 50841-1616 - Phone
- (641) 322-3722
- NPI assigned
- Dec 23, 2019
- Last updated
- Dec 23, 2019
- 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 | 17673 | IA | Primary |
Addresses
Primary practice location
625 Davis Ave
Corning, IA 50841-1616
Mailing address
625 Davis Ave
Corning, IA 50841-1616
Phone (641) 322-3722
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 |
|---|---|---|---|
| 17673 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577059200000",
"number": "1386283364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 DAVIS AVE",
"city": "CORNING",
"state": "IA",
"postal_code": "508411616",
"telephone_number": "641-322-3722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 DAVIS AVE",
"city": "CORNING",
"state": "IA",
"postal_code": "508411616",
"telephone_number": "641-322-3722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADDELL",
"first_name": "TROY",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-23",
"last_updated": "2019-12-23",
"certification_date": "2019-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "17673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corning, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.