Pioneer Market

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

49022 Issued in CA

Legal business name

PIONEER MARKET

Practice address

5034 Coakley Circle
Suite 200
Mariposa, CA 95338-2128

Phone

(209) 742-5550

Fax

(209) 742-5551

NPI assigned

Jul 15, 2008

Organization subpart

No

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

Authorized official

Name

Jason Dubberke

Title

Owner

Phone

(209) 742-5550

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Pioneer Market Pharmacy Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cody Guenthart, PHARMD

  • Pharmacist
  • Mariposa, CA
  • NPI 1942864152
  NPD

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336608000000",
    "number": "1669636932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2128",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953382128",
            "telephone_number": "209-742-5550",
            "fax_number": "209-742-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5034 COAKLEY CIRCLE",
            "address_2": "SUITE 200",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953382128",
            "telephone_number": "209-742-5550",
            "fax_number": "209-742-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER MARKET",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-15",
        "last_updated": "2012-05-10",
        "status": "A",
        "authorized_official_last_name": "DUBBERKE",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-742-5550"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "49022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1038838",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pioneer Market Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Arcelia Padilla
• Desirae Partida
• Angela Maria Phillips
• John Phillips
• John Trimmer Phillips, P.P.S.C.
• James Tony Platto, DC
• Playground of Life Marriage and Family Therapy Inc
• Paula Ploof, LCSW
• Teddi Michele Plummer
• Robert James Porta, LCSW

• Community/Retail Pharmacy in Mariposa, CA
• Providers in Mariposa, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.