Lisa Buchholz, PHARMD

Key facts

NPI

1700264355

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist 183500000X

License

1-14195 (KS)

Practice address

111 Oak St
Bonner Springs, KS 66012-1049

Phone

(913) 596-0159

NPI assigned

May 15, 2015

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Doctor of Pharmacy

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 15, 2015.

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1700264355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 N 97TH ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661093211",
            "telephone_number": "785-550-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 OAK ST",
            "city": "BONNER SPRINGS",
            "state": "KS",
            "postal_code": "660121049",
            "telephone_number": "913-596-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHHOLZ",
        "first_name": "LISA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-15",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-14195",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "0017618",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2011011745",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1D043533DE",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Bonner Springs, KS · Pharmacist in Kansas