Active NPI
Alex Daniel Vondracek, PHARM D.
- Pharmacist
- Tacoma, WA
National Provider Identifier
1548667298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 059986
- Practice address
- 9040A Jackson Avenue
Tacoma, WA 98431-1342 - Phone
- (253) 968-1950
- NPI assigned
- Nov 24, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH60648906 | WA | |
| Pharmacist | 183500000X | 059986 | NY | Primary |
Addresses
Primary practice location
9040A Jackson Avenue
Tacoma, WA 98431-1342
Mailing address
4510 N 27TH St
Tacoma, WA 98407-4610
Phone (607) 481-0615
Other practice location 1
2898 Westinghourse Road
Horseheads, NY 14845
Phone (607) 795-4293
Other practice location 2
101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4392
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
| License | State | Type | Specialty |
|---|---|---|---|
| PH60648906 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550534400000",
"number": "1548667298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4510 N 27TH ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984074610",
"telephone_number": "607-481-0615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040A JACKSON AVENUE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984311342",
"telephone_number": "253-968-1950"
}
],
"practiceLocations": [
{
"address_1": "2898 Westinghourse Road",
"address_purpose": "LOCATION",
"city": "Horseheads",
"state": "NY",
"postal_code": "14845",
"country_code": "US",
"telephone_number": "607-795-4293",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "101 Dates Dr",
"address_purpose": "LOCATION",
"city": "Ithaca",
"state": "NY",
"postal_code": "148501342",
"country_code": "US",
"telephone_number": "607-274-4392",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VONDRACEK",
"first_name": "ALEX",
"middle_name": "DANIEL",
"name_prefix": "Mr.",
"credential": "PHARM D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-24",
"last_updated": "2019-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60648906",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "059986",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.