Individual provider Active NPI

Tenjoh Ntang Fonkam, RPH

  • Pharmacist
  • Gilbert, AZ
National Provider Identifier
1689383440
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S026221 Issued in AZ
Practice address
2363 S Lindsay Rd
Gilbert, AZ 85295-4744
Phone
(480) 857-1801
NPI assigned
Nov 21, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S026221 AZ Primary

Addresses

Primary practice location

2363 S Lindsay Rd
Gilbert, AZ 85295-4744

Mailing address

2363 S Lindsay Rd
Gilbert, AZ 85295-4744
Phone (480) 857-1801

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
S026221AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Nov 27, 2022 Accepting new patients
Walgreen Co PastSince Nov 27, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1689383440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2363 S LINDSAY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852954744",
            "telephone_number": "480-857-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2363 S LINDSAY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852954744",
            "telephone_number": "480-857-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONKAM",
        "first_name": "TENJOH",
        "middle_name": "NTANG",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S026221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.