Active NPI
Donald W Smith
- Pharmacist
- Stockton, CA
National Provider Identifier
1568611531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PHP37871
- Practice address
- 104 Lincoln Ctr
Stockton, CA 95207-2607 - Phone
- (209) 956-4949
- NPI assigned
- Sep 15, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PHP37871 | CA | Primary |
Addresses
Primary practice location
104 Lincoln Ctr
Stockton, CA 95207-2607
Mailing address
937 N Yosemite St
Stockton, CA 95203-2216
Phone (209) 465-2671
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHY49148 | Other | CA | PHARMACY LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PHP37871 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Donald Wayne Smith | Current | Accepting new patients | |
| Donald Wayne Smith | Current | Accepting new patients |
Locations
937 N Yosemite St
Stockton, CA 95203
Phone (209) 465-2671
104 Lincoln Ctr
Stockton, CA 95207
Phone (209) 956-4949
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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Stockton, CA
- NPI 1033368899
-
- Community/Retail Pharmacy
- Stockton, CA
- NPI 1891737193
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221436800000",
"number": "1568611531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "937 N YOSEMITE ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952032216",
"telephone_number": "209-465-2671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 LINCOLN CTR",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952072607",
"telephone_number": "209-956-4949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "DONALD",
"middle_name": "W",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-15",
"last_updated": "2008-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "PHP37871",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE",
"identifier": "PHY49148",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.