Individual provider Active NPI

Peter Holter, R.PH.

  • Pharmacist
  • Cottonwood, AZ
National Provider Identifier
1447525985
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
52096 Issued in CA
Practice address
1100 S State Route 260
Cottonwood, AZ 86326-4640
Phone
(928) 634-9338
NPI assigned
Mar 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X S012073 AZ
Pharmacist 183500000X 52096 CA Primary

Addresses

Primary practice location

1100 S State Route 260
Cottonwood, AZ 86326-4640

Mailing address

3311 S Gillenwater Dr
Flagstaff, AZ 86005-8983
Phone (951) 526-7659

Other practice location 1

26610 Ynez Rd
Temecula, CA 92591-4697
Phone (951) 719-2002

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
S012073AZMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1331856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1447525985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 S GILLENWATER DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860058983",
            "telephone_number": "951-526-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S STATE ROUTE 260",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264640",
            "telephone_number": "928-634-9338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26610 Ynez Rd",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925914697",
            "country_code": "US",
            "telephone_number": "951-719-2002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLTER",
        "first_name": "PETER",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-16",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "AZ",
            "license": "S012073",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "52096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.