Individual provider Active NPI

Juan Jabbar Mendivil, PHARMD

  • Pharmacist
  • Tucson, AZ
National Provider Identifier
1588212849
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S023874 Issued in AZ
Practice address
9184 E Valencia Rd
Tucson, AZ 85747-4902
Phone
(520) 574-8324
NPI assigned
Aug 29, 2019
Last updated
Aug 29, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 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 S023874 AZ Primary

Addresses

Primary practice location

9184 E Valencia Rd
Tucson, AZ 85747-4902

Mailing address

9184 E Valencia Rd
Tucson, AZ 85747-4902
Phone (520) 574-8324

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
S023874AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1588212849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9184 E VALENCIA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857474902",
            "telephone_number": "520-574-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9184 E VALENCIA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857474902",
            "telephone_number": "520-574-8324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIVIL",
        "first_name": "JUAN",
        "middle_name": "JABBAR",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-29",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S023874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.