Individual provider Active NPI

Ryan Matthew Mendoza, PHARM. D.

  • Pharmacist
  • North Canton, OH
National Provider Identifier
1477788784
Registry record updated May 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03228282 Issued in OH
Practice address
7800 Cleveland Ave NW
North Canton, OH 44720-5658
Phone
(330) 499-3448
Fax
(330) 497-8253
NPI assigned
May 17, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03228282 OH Primary

Addresses

Primary practice location

7800 Cleveland Ave NW
North Canton, OH 44720-5658

Mailing address

7800 Cleveland Ave NW
North Canton, OH 44720-5658
Phone (330) 499-3448

Other identifiers 1

IdentifierTypeStateIssuer
03228282OtherOHRPH IDENTIFICATION NUMBER

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
03228282OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Ohio Inc Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1242518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242518400000",
    "number": "1477788784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 CLEVELAND AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447205658",
            "telephone_number": "330-499-3448",
            "fax_number": "330-497-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 CLEVELAND AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447205658",
            "telephone_number": "330-499-3448",
            "fax_number": "330-497-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "RYAN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-17",
        "last_updated": "2009-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03228282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RPH IDENTIFICATION NUMBER",
            "identifier": "03228282",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2009; 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.