Active NPI
Derek Dickson, PHARMD
- Pharmacist
- San Tan Valley, AZ
National Provider Identifier
1679959449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S021309
- Practice address
- 1725 W Hunt Hwy
San Tan Valley, AZ 85143-5203 - Phone
- (480) 677-2540
- Fax
- (480) 677-2562
- NPI assigned
- Aug 4, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | S021309 | AZ | Primary |
Addresses
Primary practice location
1725 W Hunt Hwy
San Tan Valley, AZ 85143-5203
Mailing address
1725 W Hunt Hwy
San Tan Valley, AZ 85143-5203
Phone (480) 677-2540
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
| License | State | Type | Specialty |
|---|---|---|---|
| S021309 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438646400000",
"number": "1679959449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1725 W HUNT HWY",
"city": "SAN TAN VALLEY",
"state": "AZ",
"postal_code": "851435203",
"telephone_number": "480-677-2540",
"fax_number": "480-677-2562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1725 W HUNT HWY",
"city": "SAN TAN VALLEY",
"state": "AZ",
"postal_code": "851435203",
"telephone_number": "480-677-2540",
"fax_number": "480-677-2562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKSON",
"first_name": "DEREK",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-04",
"last_updated": "2015-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S021309",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Tan Valley, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.