Active NPI
Timothy Aaron Cardenaz, PHARM.D.
- Pharmacist
- Sallisaw, OK
National Provider Identifier
1396014965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15017
- Practice address
- 301 J T Stites Blvd
Sallisaw, OK 74955-9302 - Phone
- (918) 774-1422
- NPI assigned
- Dec 27, 2011
- Last updated
- Dec 27, 2011
- 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 | 15017 | OK | Primary |
Addresses
Primary practice location
301 J T Stites Blvd
Sallisaw, OK 74955-9302
Mailing address
1101 Cobblestone CT
Muskogee, OK 74403-8656
Phone (580) 695-7784
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324944000000",
"number": "1396014965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 COBBLESTONE CT",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "744038656",
"telephone_number": "580-695-7784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 J T STITES BLVD",
"city": "SALLISAW",
"state": "OK",
"postal_code": "749559302",
"telephone_number": "918-774-1422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARDENAZ",
"first_name": "TIMOTHY",
"middle_name": "AARON",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-27",
"last_updated": "2011-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "15017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sallisaw, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.