Individual provider Active NPI

Jonathan K Mwathi, PHARMD

  • Pharmacist
  • Lubbock, TX
National Provider Identifier
1629551403
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
62678 Issued in TX
Practice address
9809 University Ave
Lubbock, TX 79423-5301
Phone
(214) 828-7110
NPI assigned
Sep 7, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 62678 TX Primary

Addresses

Primary practice location

9809 University Ave
Lubbock, TX 79423-5301

Mailing address

11206 University Ave
Lubbock, TX 79423-6193
Phone (214) 828-7110

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
62678TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1629551403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11206 UNIVERSITY AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794236193",
            "telephone_number": "214-828-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9809 UNIVERSITY AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794235301",
            "telephone_number": "214-828-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MWATHI",
        "first_name": "JONATHAN",
        "middle_name": "K",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-07",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "62678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; 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.