Active NPI
W Alexandria Park
- Pharmacist
- Sparks, NV
National Provider Identifier
1700169448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14825
- Practice address
- 3000 Vista Blvd
Sparks, NV 89436-6702 - Phone
- (775) 359-7044
- Fax
- (775) 359-7049
- NPI assigned
- Sep 20, 2011
- Sex
- Female
- 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 | 14825 | NV | Primary |
Addresses
Primary practice location
3000 Vista Blvd
Sparks, NV 89436-6702
Mailing address
3000 Vista Blvd
Sparks, NV 89436-6702
Phone (775) 359-7044
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14825 | NV | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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": "1316476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316476800000",
"number": "1700169448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 VISTA BLVD",
"city": "SPARKS",
"state": "NV",
"postal_code": "894366702",
"telephone_number": "775-359-7044",
"fax_number": "775-359-7049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 VISTA BLVD",
"city": "SPARKS",
"state": "NV",
"postal_code": "894366702",
"telephone_number": "775-359-7044",
"fax_number": "775-359-7049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "W",
"middle_name": "ALEXANDRIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-20",
"last_updated": "2011-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "14825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sparks, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.