Individual provider Active NPI

Neethu Alphonsa Mathew

  • Pharmacist
  • Yuma, AZ
National Provider Identifier
1497166979
Registry record updated May 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S019392 Issued in AZ
Practice address
2800 S 4TH Ave
Yuma, AZ 85364-8110
Phone
(928) 344-2341
Fax
(928) 344-5252
NPI assigned
May 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S019392 AZ Primary

Addresses

Primary practice location

2800 S 4TH Ave
Yuma, AZ 85364-8110

Mailing address

2800 S 4TH Ave
Yuma, AZ 85364-8110
Phone (928) 344-2341

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

State licenses

LicenseStateTypeSpecialty
S019392AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1400371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400371200000",
    "number": "1497166979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 S 4TH AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648110",
            "telephone_number": "928-344-2341",
            "fax_number": "928-344-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 S 4TH AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648110",
            "telephone_number": "928-344-2341",
            "fax_number": "928-344-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "NEETHU",
        "middle_name": "ALPHONSA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-18",
        "last_updated": "2014-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S019392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.