Individual provider Active NPI

Kevin Rider, PHARMD

  • Pharmacist
  • Scottsdale, AZ
National Provider Identifier
1679977169
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S018987 Issued in AZ
Practice address
14672 N Frank Lloyd Wright Blvd
Scottsdale, AZ 85260-2043
Phone
(480) 661-2936
Fax
(480) 661-7155
NPI assigned
Oct 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S018987 AZ Primary

Addresses

Primary practice location

14672 N Frank Lloyd Wright Blvd
Scottsdale, AZ 85260-2043

Mailing address

14672 N Frank Lloyd Wright Blvd
Scottsdale, AZ 85260-2043
Phone (480) 661-2936

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
S018987AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1679977169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14672 N FRANK LLOYD WRIGHT BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602043",
            "telephone_number": "480-661-2936",
            "fax_number": "480-661-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14672 N FRANK LLOYD WRIGHT BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602043",
            "telephone_number": "480-661-2936",
            "fax_number": "480-661-7155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDER",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-14",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S018987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.