Individual provider Active NPI

Zachary L Roberts, PHARMD

  • Pharmacist
  • Fort Wayne, IN
National Provider Identifier
1497038574
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26022083A Issued in IN
Practice address
12279 Bluffton Road
Fort Wayne, IN 46809
Phone
(734) 343-7606
NPI assigned
Sep 24, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26022083A IN Primary

Addresses

Primary practice location

12279 Bluffton Road
Fort Wayne, IN 46809

Mailing address

2565 Alexandra Dr
Carmel, IN 46074-5874
Phone (317) 919-2384

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
26022083AINMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health Pharmacy Services, LLC CurrentSince Nov 27, 2022 Accepting new patients
Trinity Health Pharmacy Services, LLC CurrentSince Nov 24, 2019 Accepting new patients
Walgreen Co Past Accepting new patients

Locations

12279 Bluffton Rd
Fort Wayne, IN 46809
Phone (734) 343-7600

Organizations & group practices 3

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": "1316822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1497038574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2565 ALEXANDRA DR",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460745874",
            "telephone_number": "317-919-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12279 BLUFFTON ROAD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46809",
            "telephone_number": "734-343-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ZACHARY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-24",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26022083A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

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

Verify at the official NPI Registry.