Individual provider Active NPI

Jayden Lee, PHARMD

  • Ambulatory Care Pharmacist
  • Green Valley, AZ
National Provider Identifier
1649663329
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
S025192 Issued in AZ
Practice address
919 W Rio Altar
Green Valley, AZ 85614-4036
Phone
(818) 398-8121
NPI assigned
Mar 5, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Pharmacist 1835P2201X RPH029713 GA
Ambulatory Care Pharmacist 1835P2201X S025192 AZ Primary
Pharmacist 183500000X PCT.0012000 CT

Addresses

Primary practice location

919 W Rio Altar
Green Valley, AZ 85614-4036

Mailing address

919 W Rio Altar
Green Valley, AZ 85614-4036
Phone (818) 398-8121

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
PCT.0012000CTMDPharmacist
S025192AZMDAmbulatory Care Pharmacist
RPH029713GAMDAmbulatory Care Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC PastSince Jun 1, 2021 Accepting new patients
Banner Primary Care Physicians Arizona LLC PastSince Jun 1, 2021 Accepting new patients
My Pharmacist Friend, LLC PastSince Nov 8, 2020 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1649663329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 W RIO ALTAR",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856144036",
            "telephone_number": "818-398-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 W RIO ALTAR",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856144036",
            "telephone_number": "818-398-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JAYDEN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-05",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "GA",
            "license": "RPH029713",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "AZ",
            "license": "S025192",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0012000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.