Individual provider Active NPI

Lily Ann Rodgers, R.PH.

  • Pharmacist
  • Glendale, AZ
National Provider Identifier
1669894077
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
08277 Issued in AZ
Practice address
5605 W Northern Ave
Glendale, AZ 85301-1332
Phone
(623) 934-7926
Fax
(623) 934-7929
NPI assigned
Jan 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 08277 AZ Primary
Pharmacist 183500000X 03994 NM

Addresses

Primary practice location

5605 W Northern Ave
Glendale, AZ 85301-1332

Mailing address

29315 N 140TH St
Scottsdale, AZ 85262-5505
Phone (602) 618-1616

Other identifiers 2

IdentifierTypeStateIssuer
03994OtherNMREGISTERED PHARMACIST
08277OtherAZREGISTERED PHARMACIST

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

LicenseStateTypeSpecialty
08277AZMDPharmacist
03994NMMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1669894077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29315 N 140TH ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852625505",
            "telephone_number": "602-618-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5605 W NORTHERN AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853011332",
            "telephone_number": "623-934-7926",
            "fax_number": "623-934-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "LILY",
        "middle_name": "ANN",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-21",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "08277",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "03994",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED PHARMACIST",
            "identifier": "03994",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED PHARMACIST",
            "identifier": "08277",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; 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.