Individual provider Active NPI

Janis Lynne Victor, RPH

  • Pharmacist
  • Parker, AZ
National Provider Identifier
1447662648
Registry record updated May 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S020425 Issued in AZ
Practice address
100 Riverside Dr
Walmart Pharmacy
Parker, AZ 85344
Phone
(928) 669-8306
Fax
(928) 669-8357
NPI assigned
May 22, 2014
Last updated
May 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S020425 AZ Primary
Pharmacist 183500000X 18018 NV
Pharmacist 183500000X 5302023547 MI
Pharmacist 183500000X PS32405 FL

Addresses

Primary practice location

100 Riverside Dr
Walmart Pharmacy
Parker, AZ 85344

Mailing address

100 Riverside Dr
Walmart Pharmacy
Parker, AZ 85344
Phone (928) 669-8306

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
S020425AZMDPharmacist
PS32405FLMDPharmacist
5302023547MIMDPharmacist
18018NVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walmart Inc. PastSince Dec 29, 2024 Accepting new patients
Walmart Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400716800000",
    "number": "1447662648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RIVERSIDE DR",
            "address_2": "WALMART PHARMACY",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "85344",
            "telephone_number": "928-669-8306",
            "fax_number": "928-669-8357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RIVERSIDE DR",
            "address_2": "WALMART PHARMACY",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "85344",
            "telephone_number": "928-669-8306",
            "fax_number": "928-669-8357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTOR",
        "first_name": "JANIS",
        "middle_name": "LYNNE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2014-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S020425",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "18018",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302023547",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS32405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2014; 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.