Individual provider Active NPI

Anthony Kyle Davis

  • Pharmacist
  • Olathe, KS
National Provider Identifier
1629680178
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
1-100836 Issued in KS
Practice address
13450 S Blackbob Rd
Olathe, KS 66062-1503
Phone
(913) 829-3176
NPI assigned
Aug 17, 2020
Last updated
Aug 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 1-100836 KS Primary

Addresses

Primary practice location

13450 S Blackbob Rd
Olathe, KS 66062-1503

Mailing address

13450 S Blackbob Rd
Olathe, KS 66062-1503
Phone (913) 829-3176

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
1-100836KSMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1629680178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13450 S BLACKBOB RD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621503",
            "telephone_number": "913-829-3176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13450 S BLACKBOB RD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621503",
            "telephone_number": "913-829-3176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ANTHONY",
        "middle_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-100836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.