Active NPI
Stanley Kupata Mwendar, RPH
- Psychiatric Pharmacist
- Phoenix, AZ
National Provider Identifier
1659970325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Pharmacist
- License
- S016062
- Practice address
- 1209 S 1St Ave
Phoenix, AZ 85003-2605 - Phone
- (602) 282-8006
- NPI assigned
- Oct 22, 2020
- 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 |
|---|---|---|---|---|
| Psychiatric Pharmacist | 1835P1300X | S016062 | AZ | Primary |
Addresses
Primary practice location
1209 S 1St Ave
Phoenix, AZ 85003-2605
Mailing address
5525 E Thomas Rd Unit D3
Phoenix, AZ 85018-8158
Phone (480) 290-6632
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S016062 | AZ | MD | Psychiatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1659970325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5525 E THOMAS RD UNIT D3",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850188158",
"telephone_number": "480-290-6632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1209 S 1ST AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850032605",
"telephone_number": "602-282-8006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MWENDAR",
"first_name": "STANLEY",
"middle_name": "KUPATA",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-22",
"last_updated": "2020-10-22",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "AZ",
"license": "S016062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.